{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T07:16:20Z","timestamp":1788419780800,"version":"build-2803163510"},"reference-count":36,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T00:00:00Z","timestamp":1788393600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychiatry"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Nutritional rehabilitation is widely considered a prerequisite for recovery in anorexia nervosa (AN), given the profound effects of malnutrition on cognitive, emotional, and behavioral functioning. However, whether psychiatric improvement during residential treatment is directly coupled with the degree of nutritional restoration remains insufficiently understood. This study investigated longitudinal changes in body composition and psychosocial outcomes during residential psychiatric rehabilitation for AN, with the aim of informing the evaluation and planning of intensive rehabilitation programmes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This exploratory longitudinal observational study included 19 female patients with AN or atypical AN (mean age 20.4 \u00b1 5.6 years) admitted to a specialized residential programme. Multi-frequency bioelectrical impedance analysis (BIA) was performed at admission (T0) and discharge (T1; \u2248 5 months). Diagnoses were confirmed via the Eating Disorder Examination (EDE) and psychiatric comorbidities via the SCID-5. Psychopathology and body image were assessed using the EDE-Q, EDI-3, SCL-90, CIA, EDS-R, and BUT. Wilcoxon signed-rank tests evaluated T0\u2013T1 changes; Spearman correlations assessed nutritional-psychiatric associations. Benjamini-Hochberg correction was applied to all secondary outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>BMI increased significantly (p = 0.042, r = 0.35), whereas FFM and SMM showed non-significant medium-effect-size upward trends. Large and significant improvements were observed in eating disorder psychopathology (EDE-Q: r = 0.74), psychological distress (SCL-90 GSI: r = 0.66), functional impairment (CIA: r = 0.62), exercise dependence (EDS-R: r = 0.72), and body image disturbance (BUT GSI: r = 0.88, the largest effect size in the study). Sixteen of 18 EDI-3 subscales, all nine SCL-90 dimensions, all seven EDS-R subscales, and all seven BUT-A indices improved significantly after false discovery rate correction. Nutritional and psychiatric change scores were not significantly correlated across any pairing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Five months of residential treatment produced large-magnitude psychiatric improvements alongside modest nutritional gains. The absence of significant somatic-psychiatric correlations should be interpreted with caution: the study had only 37.5% power to detect medium-sized associations (rs = 0.40), yielding a Type II error probability of approximately 62.5%. These findings are hypothesis-generating and do not permit inference about the degree of coupling between nutritional and psychiatric recovery in AN.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpsyt.2026.1883192","type":"journal-article","created":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T06:42:55Z","timestamp":1788417775000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Psychosocial recovery and nutritional rehabilitation in residential treatment for anorexia nervosa: an exploratory longitudinal multi-frequency bioelectrical impedance analysis study"],"prefix":"10.3389","volume":"17","author":[{"given":"Francesco","family":"Monaco","sequence":"first","affiliation":[{"name":"Department of Mental Health ASL Salerno","place":["Salerno, Italy"]},{"name":"European Biomedical Research Institute of Salerno","place":["Salerno, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annarita","family":"Vignapiano","sequence":"additional","affiliation":[{"name":"Department of Mental Health ASL Salerno","place":["Salerno, Italy"]},{"name":"European Biomedical Research Institute of Salerno","place":["Salerno, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefania","family":"Landi","sequence":"additional","affiliation":[{"name":"Department of Mental Health ASL Salerno","place":["Salerno, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rossella","family":"Bonifacio","sequence":"additional","affiliation":[{"name":"Department of Mental Health ASL Salerno","place":["Salerno, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela","family":"Falchetta","sequence":"additional","affiliation":[{"name":"Department of Mental Health ASL Salerno","place":["Salerno, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emanuela","family":"Ferrara","sequence":"additional","affiliation":[{"name":"Department of Mental Health ASL Salerno","place":["Salerno, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ernesta","family":"Panarello","sequence":"additional","affiliation":[{"name":"Department of Mental Health ASL Salerno","place":["Salerno, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruno","family":"Attianese","sequence":"additional","affiliation":[{"name":"Department of Mental Health ASL Salerno","place":["Salerno, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annaluce","family":"Caputo","sequence":"additional","affiliation":[{"name":"Department of Mental Health ASL Salerno","place":["Salerno, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr","given":"Luca","family":"Steardo","sequence":"additional","affiliation":[{"name":"Department of Mental Health ASL Salerno","place":["Salerno, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gennaro","family":"Sosto","sequence":"additional","affiliation":[{"name":"General Management, ASL Salerno","place":["Salerno, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulio","family":"Corrivetti","sequence":"additional","affiliation":[{"name":"Department of Mental Health ASL Salerno","place":["Salerno, Italy"]},{"name":"European Biomedical Research Institute of Salerno","place":["Salerno, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,3]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1016\/S2215-0366(14)00051-0","article-title":"Nutritional medicine as mainstream in psychiatry","volume":"2","author":"Sarris","year":"2015","journal-title":"Lancet Psychiatry"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1016\/j.euroneuro.2019.10.011","article-title":"Nutritional psychiatry: Towards improving mental health by what you eat","volume":"29","author":"Adan","year":"2019","journal-title":"Eur Neuropsychopharmacol"},{"key":"B3","volume-title":"Diagnostic and Statistical Manual of Mental Disorders","year":"2013"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1016\/S2215-0366(15)00356-9","article-title":"Anorexia nervosa: Aetiology, assessment, and treatment","volume":"2","author":"Zipfel","year":"2015","journal-title":"Lancet Psychiatry"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1002\/eat.23158","article-title":"Body composition in anorexia nervosa: Meta-analysis and meta-regression of cross-sectional and longitudinal studies","volume":"52","author":"H\u00fcbel","year":"2019","journal-title":"Int J Eat Disord"},{"key":"B6","doi-asserted-by":"publisher","first-page":"167","DOI":"10.1186\/s40337-022-00702-x","article-title":"Body composition and energy expenditure in anorexia nervosa: Preliminary data of outpatients with recovering and active disease","volume":"10","author":"Dos Reis","year":"2022","journal-title":"J Eat Disord"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1016\/j.numecd.2024.08.021","article-title":"Longitudinal trends of body composition in anorexia nervosa: Cardiac functioning impacts restoration of fat-free mass at three months","volume":"35","author":"Tarchi","year":"2024","journal-title":"Nutr Metab Cardiovasc Dis"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph182111388","article-title":"Comparison of dual-energy X-ray absorptiometry and bioelectrical impedance analysis in the assessment of body composition in women with anorexia nervosa upon admission and discharge from an inpatient specialist unit","volume":"18","author":"Abbaspour","year":"2021","journal-title":"Int J Environ Res Public Health"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.3390\/nu16101539","article-title":"Bioelectrical impedance vector analysis, nutritional ultrasound, and handgrip strength as innovative methods for monitoring critical anorexia nervosa physical recovery: A pilot study","volume":"16","author":"Romero-M\u00e1rquez","year":"2024","journal-title":"Nutrients"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1093\/nutrit\/nuaf221","article-title":"Using bioelectrical impedance analysis to assess body composition changes in female patients with anorexia nervosa during physical recovery","volume":"84","author":"Edwards","year":"2025","journal-title":"Nutr Rev"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1186\/s40337-024-01048-2","article-title":"Maladaptive exercise in eating disorders: Lifetime and current impact on mental health and treatment seeking","volume":"12","author":"Liao","year":"2024","journal-title":"J Eat Disord"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1080\/10640266.2021.1895509","article-title":"A systematic review of treatment approaches for compulsive exercise among individuals with eating disorders","volume":"30","author":"Hallward","year":"2022","journal-title":"Eat Disord"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1002\/eat.24108","article-title":"Effects of inpatient treatment on compulsive exercise in adults with longstanding eating disorders: Secondary analysis from a randomized controlled trial with 12-month follow-up","volume":"57","author":"Vrabel","year":"2024","journal-title":"Int J Eat Disord"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.2471\/BLT.07.043497","article-title":"Development of a WHO growth reference for school-aged children and adolescents","volume":"85","author":"de Onis","year":"2007","journal-title":"Bull World Health Organ"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1007\/BF03344156","article-title":"Italian cross-sectional growth charts for height, weight and BMI (2 to 20 yr)","volume":"29","author":"Cacciari","year":"2006","journal-title":"J Endocrinol Invest"},{"key":"B16","volume-title":"Linee Di Indirizzo Nazionali Per La Riabilitazione Nutrizionale Nei Disturbi Dell\u2019alimentazione","year":"2017"},{"key":"B17","volume-title":"The Eating Disorder Examination (12th Edition)","author":"Fairburn","year":"1993"},{"key":"B18","volume-title":"Structured Clinical Interview for DSM-5 Disorders \u2014 Clinician Version (Scid-5-Cv)","author":"First","year":"2015"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1016\/S0005-7967(03)00161-X","article-title":"Validity of the Eating Disorder Examination Questionnaire (EDE-Q) in screening for eating disorders in community samples","volume":"42","author":"Mond","year":"2004","journal-title":"Behav Res Ther"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1080\/15374410802698697","article-title":"Prevalence and characteristics of binge eating in an adolescent community sample","volume":"38","author":"Goossens","year":"2012","journal-title":"J Clin Child Adolesc Psychol"},{"key":"B21","volume-title":"Eating Disorder Inventory-3: Professional Manual","author":"Garner","year":"2004"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1016\/j.eurpsy.2010.12.006","article-title":"Psychometric properties of the Italian version of the SCL-90-R: A study on a large community sample","volume":"27","author":"Prunas","year":"2012","journal-title":"Eur Psychiatry"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1016\/j.brat.2008.06.012","article-title":"The measurement of impairment due to eating disorder psychopathology","volume":"46","author":"Bohn","year":"2008","journal-title":"Behav Res Ther"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1556\/JBA.1.2012.009","article-title":"Psychometric examination and factorial validity of the Exercise Dependence Scale-Revised in Italian exercisers","volume":"1","author":"Costa","year":"2012","journal-title":"J Behav Addict"},{"key":"B25","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/BF03327738","article-title":"The Body Uneasiness Test (BUT): Development and validation of a new body image assessment scale","volume":"11","author":"Cuzzolaro","year":"2006","journal-title":"Eat Weight Disord"},{"key":"B26","article-title":"Eating disorder examination questionnaire (EDE-Q 6.0)","author":"Fairburn","year":"2008","journal-title":"Cognitive Behavior Therapy and Eating Disorders"},{"key":"B27","article-title":"Eating disorder examination questionnaire (EDE-Q 6.0)","volume-title":"Cognitive Behavior Therapy and Eat. Disord","author":"Fairburn","year":"2008"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1007\/s40519-016-0276-6","article-title":"The Eating Disorder Examination Questionnaire: Reliability and validity of the Italian version","volume":"22","author":"Calugi","year":"2017","journal-title":"Eat Weight Disord"},{"key":"B29","volume-title":"SCL-90-R: Administration, Scoring, and Procedures Manual","author":"Derogatis","year":"1977"},{"key":"B30","volume-title":"SCL-90-R: Administration, Scoring, and Procedures Manual","author":"Derogatis","year":"1994"},{"key":"B31","article-title":"Clinical impairment assessment questionnaire (CIA 3.0)","volume-title":"Cognitive Behavior Therapy and Eat. Disord","author":"Bohn","year":"2008"},{"key":"B32","doi-asserted-by":"publisher","first-page":"387","DOI":"10.1080\/0887044022000004894","article-title":"How much is too much? The development and validation of the Exercise Dependence Scale","volume":"17","author":"Hausenblas","year":"2002","journal-title":"Psychol Health"},{"key":"B33","doi-asserted-by":"publisher","first-page":"183","DOI":"10.1207\/s15327841mpee0804_1","article-title":"Factorial validity and psychometric examination of the Exercise Dependence Scale-Revised","volume":"8","author":"Symons Downs","year":"2004","journal-title":"Meas Phys Educ Exerc Sci"},{"key":"B34","volume-title":"R: A Language and Environment for Statistical Computing","year":"2024"},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpsc.2017.12.004","article-title":"Interoception and mental health: A roadmap","volume":"3","author":"Khalsa","year":"2018","journal-title":"Biol Psychiatry Cognit Neurosci Neuroimaging"},{"key":"B36","doi-asserted-by":"publisher","DOI":"10.3390\/nu12010183","article-title":"Physical activity in eating disorders: A systematic review","volume":"12","author":"Rizk","year":"2020","journal-title":"Nutrients"}],"container-title":["Frontiers in Psychiatry"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyt.2026.1883192\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T06:42:58Z","timestamp":1788417778000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyt.2026.1883192\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,3]]},"references-count":36,"alternative-id":["10.3389\/fpsyt.2026.1883192"],"URL":"https:\/\/doi.org\/10.3389\/fpsyt.2026.1883192","relation":{},"ISSN":["1664-0640"],"issn-type":[{"value":"1664-0640","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,3]]},"article-number":"1883192"}}