Anorexia Nervosa
Conditions
Brief summary
To evaluate if TMS together with a body image intervention is an efficacious treatment for anorexia nervosa compared to treatment as usual.
Interventions
DEVICETranscranial magnetic stimulation
TMS (theta burst) will be administered consisting of bursts containing 3 pulses at 50 Hz and an intensity of 80% motor threshold repeated at 200 ms intervals (i.e., at 5 Hz) and a 10 s between burst triplet interval for a total for 190 s (600 pulses). The intervention will be given daily 5 times/week during 4 weeks.
BEHAVIORALBody Image Intervention
Body image interventions delivered directly after TMS will include body exercises that target disturbed body image and psychoeducation about the body. Together with a therapist the participants with anorexia nervosa will explore and estimate their body size through feedback.
BEHAVIORALTreatment as usual
Treatment as usual at the eating disorder unit, Child and adolescent psychiatric clinic and Psychiatric clinic is delivered during 4 weeks
Sponsors
Region Östergötland
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
TRIPLE (Subject, Caregiver, Outcomes Assessor)
Eligibility
Sex/Gender
FEMALE
Age
18 Years to 35 Years
Healthy volunteers
Yes
Inclusion criteria
* Being enrolled as a patient at the eating disorder unit of the Child and adolescent psychiatric clinic and Psychiatric clinic in Linköping * Having a DSM-5 diagnosis of anorexia nervosa, atypical anorexia (restrictive type) * Being at least 18 years of age * Having a BMI of 20 or under. * Being free of psychotropic medications or on stable (at least three months on the same dose) medication.
Exclusion criteria
* Clinical diagnosis of schizophrenia or psychotic disorder * Clinical diagnosis of bipolar disorder * Alcohol/drug dependence * Ongoing treatment with antipsychotics or tricyclic antidepressants * Previous severe head injury * Birth before 33 weeks of gestation * Hearing impairment * Earlier epilepsy or seizures of other causes * Having severe claustrophobia * Being pregnant * Having a cognitive disability
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Body Attitude Test (BAT) | Change from baseline at 4 weeks and at 6 months | BAT measures attitudes toward one own body. It contains a total of 20 items that are rated on a Likert scale between 0-5. Total scores range from 0-100. Higher scores indicate more problems with body attitude. |
| Figure Rating Scale | Change from baseline at 4 weeks and at 6 months | Figure Rating Scale measures body image and estimation of one's own body size. Each figure presents nine schematic silhouettes, ranging from extreme thinness (1) to extreme obesity (9). For research purposes, participants are asked to self-select the silhouette that best indicates his or her current body size (ranging from 1-9) and the silhouette that reflects his or her ideal body size (ranging from 1-9). |
| Body Mass Index (BMI) | Change from baseline at 4 weeks and at 6 months | Body Mass Index is a person's weight in kilograms divided by the square of height in meters and is an indication of under- or overweight in adults. |
| Eating Disorder Examination Questionnaire (EDE-Q) | Change from baseline at 4 weeks and at 6 months | EDE-Q measures symptoms of eating disorder. It contains at total of 36 items. 23 of these are rated on a Likert scale between 0-6 and contains 4 subscales: Restraint (ranging from 0-30); Eating concern (ranging from 0-30); shape concern (ranging from 0-48); weight concern (ranging from 0-30). Higher scores indicating more difficulties with eating disorder. In addition, 11 open ended questions concern binge eating and compensating behaviors. |
| Body Shape Questionnaire (BSQ) | Change from baseline at 4 weeks and at 6 months | BSQ measures dissatisfaction with one's own body/figure. It contains a total of 34 items, which are rated on a Likert scale ranging from 1-6. total scores range from 34-204, with higher scores indicating more dissatisfaction. |
Other
| Measure | Time frame |
|---|---|
| Extrastriatal body area (EBA) connectivity during resting state fMRI | Change from baseline at 4 weeks and at 6 months |
| Extrastriatal body area (EBA) activation during fMRI | Change from baseline at 4 weeks and at 6 months |
Countries
Sweden
Contacts
Primary ContactMaria A Zetterqvist, PhD
Backup ContactRebecca Böhme, PhD
Outcome results
None listed