Treatment of Eating Disorders across the Age Range: Matching Patient Characteristics to Interventions

Established: April 2007; first big stakeholder meeting will take place in June 2007.

Convenor (Chair): Professor Ulrike Schmidt, Professor of Eating Disorders, Institute of Psychiatry, King’s College London; contact u.schmidt@iop.kcl.ac.uk

Members: consists of academics with a track record in clinical eating disorders (ED) research, including 16 psychiatrists, 5 psychologists, 2 neuroscientists and one health economist:
1. Dr. Jennifer Beecham, Senior Lecturer and Deputy Director, Centre for the Economics of Mental Health and Reader in Social Policy, Personal Social Services Research Unit, University of Kent, Canterbury
2. Dr. Mark Berelowitz Honorary Senior Lecturer in Child Psychiatry, Royal Free Hospital
3. Prof. Iain Campbell, Professor of Neurochemistry, Institute of Psychiatry
4. Prof. David Collier, Professor of Neuropsychiatric Genetics, Institute of Psychiatry
5. Dr. Ivan Eisler, Reader in Family Psychology and Family Therapy, Institute of Psychiatry
6. Prof. Christopher Fairburn, Wellcome Trust Principal Research Fellow and Professor of Psychiatry, University of Oxford
7. Prof. Simon Gowers, Professor of Adolescent Psychiatry, University of Liverpool and Consultant and Lead Clinician, Cheshire & Merseyside Eating Disorders Service for Adolescents
8. Prof. Andrew Hill, Professor of Medical Psychology, Leeds University
9. Dr. Tony Jaffa, Consultant Child & Adolescent Psychiatrist, Psychiatrist and Associate Lecturer University of Cambridge
10. Dr. Anthony James, Consultant Adolescent Psychiatrist and Clinical Senior Lecturer, Oxford.
11. Prof. Hubert Lacey, Professor of Psychiatry, St. George’s Hospital Medical School, London.
12. Prof. Bryan Lask, Emeritus Professor of Child and Adolescent Psychiatry at St George’s University of London, Medical Adviser to the Huntercombe Hospital Group, UK, Visiting Professor, Oslo, University, Norway.
13. Dr. Caroline Meyer, Reader in Psychology, Loughborough University
14. Dr. John Morgan, Senior Lecturer and Consultant in Eating Disorders, Director of the Yorkshire, Centre for Eating Disorders
15. Dr. Dasha Nicholls, Consultant in Child and Adolescent Psychiatry, Great Ormond Street Hospital, Honorary Senior Lecturer, Institute of Child Health, London
16. Prof. Bob Palmer, Professor of Psychiatry, University of Leicester
17. Dr. Rebecca Park, Clinical Senior Lecturer, Department of Psychiatry, Oxford
18. Dr. Paul Robinson, Consultant Psychiatrist Royal Free Hospital and Honorary Senior Lecturer, University College, London.
19. Dr. Kate Tchanturia, Consultant Clinical Psychologist and Lecturer
20. Prof. Janet Treasure, Professor of Psychiatry, GKT Medical School
21. Prof. Glenn Waller, Visiting Professor of Psychology, Institute of Psychiatry, and Consultant Clinical Psychologist, Vincent Square, Eating Disorders Unit
22. Dr. Geoffrey Wolff, Honorary Senior Lecturer, Institute of Psychiatry, Consultant Psychiatrist, South London & Maudsley NHS Trust, London.

Devolved nation members:
23. Dr. Chris Williams, Senior Lecturer in Psychiatry, University of Glasgow

Service User and Carer Input:
This will be provided by beat (formerly known as Eating Disorders Association), the UK’s leading Charity for people with ED and their families. The EDA will be represented in the proposed group by their Chief Executive Ms Susan Ringwood. The Beat data base of approximately of 200 service users and carers who have declared their interest in participating in research will be used to invite service users interested in participating in the group.

Remit and Aims:
Early detection and treatment of ED are compromised by young people’s reluctance to seek help and/or dissatisfaction with the ‘watchful waiting approach’ used by general practitioners. Few receive specialist treatment.

Effective evidence-based treatments for some types of ED exist, such as family- interventions for adolescents with AN and a special form of CBT for BN and BED. Access to these treatments is limited; many parts of the UK lack specialist ED services.

Treatment outcomes in adults with AN remain poor and relapse rates are high. Little is known about how to work psychologically with patients with severe or chronic AN.

Projects developed by this group will aim to (a) improve our understanding of ED and what causes and maintains them and (b) develop more effective, accessible and cost effective treatments tailored to the clinical, personality, genetic and neuropsychological characteristics of patients and their carers.

Research methods will include randomised controlled treatment trials and multi-modal investigations of treatment-resistant or chronic cases [e.g. large case series using multiple baseline across subjects designs; and studies of biological (e.g. genetic) and psychological (cognitive/emotional processing] factors implicated in aetiology, course and outcome.

Current Status & Future Plans:
1. To develop and test interventions for the early detection and treatment of young people with ED so as to prevent chronicity and reduce the developmental impact of these disorders.

2. To develop and test improved treatments for adults with AN that target disease-maintaining factors, are matched to symptoms, personality, genetic and neuropsychological profile and which can also be used as intensive modules in in-patients with AN.

3. To evaluate the efficacy and cost-effectiveness of interventions, designed to improve carer outcomes (e.g. distress, care giving efficacy). There are a range of carer-interventions for people with AN consisting of a web-based programme, DVDs and a workbook and intensive piloting of these has been carried out.

These types of projects would be greatly aided by a multi-disciplinary and multi-centre approach.

6 month update report (Sept 07):
The group had its inaugural stakeholder meeting on 14th of June 2007 at Great Ormond Street Hospital, London. The meeting was attended by 33 researchers, clinicians, service user and carer representatives. A number of project proposals were discussed and two of these have been selected to go forward to the MHRN for adoption.

Update report (March 08)