The Maudsley Outpatient Study of Treatments for Anorexia Nervosa and Related Conditions (MOSAIC): Comparison of the Maudsley Model of Anorexia Nervosa Treatment for Adults (MANTRA) With Specialist Supportive Clinical Management (SSCM) in Outpatients With Broadly Defined Anorexia Nervosa: A Randomized Controlled Trial

Ulrike Schmidt; Nicholas Magill; Bethany Renwick; Alexandra Keyes; Martha Kenyon; Hannah Dejong; Anna Lose; Hannah Broadbent; Rachel Loomes; Huma Yasin; Charlotte Watson; Shreena Ghelani; Eva-Maria Bonin; Lucy Serpell; Lorna Richards; Eric Johnson-Sabine; Nicky Boughton; Linette Whitehead; Jennifer Beecham; Janet Treasure; Sabine Landau

doi:10.1037/ccp0000019

The Maudsley Outpatient Study of Treatments for Anorexia Nervosa and Related Conditions (MOSAIC): Comparison of the Maudsley Model of Anorexia Nervosa Treatment for Adults (MANTRA) With Specialist Supportive Clinical Management (SSCM) in Outpatients With Broadly Defined Anorexia Nervosa: A Randomized Controlled Trial

Ulrike Schmidt, Nicholas Magill, Bethany Renwick, Alexandra Keyes, Martha Kenyon, Hannah Dejong, Anna Lose, Hannah Broadbent, Rachel Loomes, Huma Yasin, Charlotte Watson, Shreena Ghelani, Eva-Maria Bonin, Lucy Serpell, Lorna Richards, Eric Johnson-Sabine, Nicky Boughton, Linette Whitehead, Jennifer Beecham, Janet TreasureSabine Landau

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Abstract

OBJECTIVE: Anorexia nervosa (AN) in adults has poor outcomes, and treatment evidence is limited. This study evaluated the efficacy and acceptability of a novel, targeted psychological therapy for AN (Maudsley Model of Anorexia Nervosa Treatment for Adults; MANTRA) compared with Specialist Supportive Clinical Management (SSCM).

METHOD: One hundred forty-two outpatients with broadly defined AN (body mass index [BMI] ≤ 18.5 kg/m2) were randomly allocated to receive 20 to 30 weekly sessions (depending on clinical severity) plus add-ons (4 follow-up sessions, optional sessions with dietician and with carers) of MANTRA (n = 72) or SSCM (n = 70). Assessments were administered blind to treatment condition at baseline, 6 months, and 12 months after randomization. The primary outcome was BMI at 12 months. Secondary outcomes included eating disorders symptomatology, other psychopathology, neuro-cognitive and social cognition, and acceptability. Additional service utilization was also assessed. Outcomes were analyzed using linear mixed models.

RESULTS: Both treatments resulted in significant improvements in BMI and reductions in eating disorders symptomatology, distress levels, and clinical impairment over time, with no statistically significant difference between groups at either 6 or 12 months. Improvements in neuro-cognitive and social-cognitive measures over time were less consistent. One SSCM patient died. Compared with SSCM, MANTRA patients rated their treatment as significantly more acceptable and credible at 12 months. There was no significant difference between groups in additional service consumption.

CONCLUSIONS: Both treatments appear to have value as first-line outpatient interventions for patients with broadly defined AN. Longer term outcomes remain to be evaluated.

Original language	English
Pages (from-to)	796-807
Journal	Journal of Consulting and Clinical Psychology
Volume	83
Issue number	4
DOIs	https://doi.org/10.1037/ccp0000019
Publication status	Published - Aug 2015

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Schmidt, U., Magill, N., Renwick, B., Keyes, A., Kenyon, M., Dejong, H., Lose, A., Broadbent, H., Loomes, R., Yasin, H., Watson, C., Ghelani, S., Bonin, E.-M., Serpell, L., Richards, L., Johnson-Sabine, E., Boughton, N., Whitehead, L., Beecham, J., ... Landau, S. (2015). The Maudsley Outpatient Study of Treatments for Anorexia Nervosa and Related Conditions (MOSAIC): Comparison of the Maudsley Model of Anorexia Nervosa Treatment for Adults (MANTRA) With Specialist Supportive Clinical Management (SSCM) in Outpatients With Broadly Defined Anorexia Nervosa: A Randomized Controlled Trial. Journal of Consulting and Clinical Psychology, 83(4), 796-807. https://doi.org/10.1037/ccp0000019

Schmidt, Ulrike ; Magill, Nicholas ; Renwick, Bethany et al. / The Maudsley Outpatient Study of Treatments for Anorexia Nervosa and Related Conditions (MOSAIC) : Comparison of the Maudsley Model of Anorexia Nervosa Treatment for Adults (MANTRA) With Specialist Supportive Clinical Management (SSCM) in Outpatients With Broadly Defined Anorexia Nervosa: A Randomized Controlled Trial. In: Journal of Consulting and Clinical Psychology. 2015 ; Vol. 83, No. 4. pp. 796-807.

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title = "The Maudsley Outpatient Study of Treatments for Anorexia Nervosa and Related Conditions (MOSAIC): Comparison of the Maudsley Model of Anorexia Nervosa Treatment for Adults (MANTRA) With Specialist Supportive Clinical Management (SSCM) in Outpatients With Broadly Defined Anorexia Nervosa: A Randomized Controlled Trial",

abstract = "OBJECTIVE: Anorexia nervosa (AN) in adults has poor outcomes, and treatment evidence is limited. This study evaluated the efficacy and acceptability of a novel, targeted psychological therapy for AN (Maudsley Model of Anorexia Nervosa Treatment for Adults; MANTRA) compared with Specialist Supportive Clinical Management (SSCM).METHOD: One hundred forty-two outpatients with broadly defined AN (body mass index [BMI] ≤ 18.5 kg/m2) were randomly allocated to receive 20 to 30 weekly sessions (depending on clinical severity) plus add-ons (4 follow-up sessions, optional sessions with dietician and with carers) of MANTRA (n = 72) or SSCM (n = 70). Assessments were administered blind to treatment condition at baseline, 6 months, and 12 months after randomization. The primary outcome was BMI at 12 months. Secondary outcomes included eating disorders symptomatology, other psychopathology, neuro-cognitive and social cognition, and acceptability. Additional service utilization was also assessed. Outcomes were analyzed using linear mixed models.RESULTS: Both treatments resulted in significant improvements in BMI and reductions in eating disorders symptomatology, distress levels, and clinical impairment over time, with no statistically significant difference between groups at either 6 or 12 months. Improvements in neuro-cognitive and social-cognitive measures over time were less consistent. One SSCM patient died. Compared with SSCM, MANTRA patients rated their treatment as significantly more acceptable and credible at 12 months. There was no significant difference between groups in additional service consumption.CONCLUSIONS: Both treatments appear to have value as first-line outpatient interventions for patients with broadly defined AN. Longer term outcomes remain to be evaluated.",

author = "Ulrike Schmidt and Nicholas Magill and Bethany Renwick and Alexandra Keyes and Martha Kenyon and Hannah Dejong and Anna Lose and Hannah Broadbent and Rachel Loomes and Huma Yasin and Charlotte Watson and Shreena Ghelani and Eva-Maria Bonin and Lucy Serpell and Lorna Richards and Eric Johnson-Sabine and Nicky Boughton and Linette Whitehead and Jennifer Beecham and Janet Treasure and Sabine Landau",

year = "2015",

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doi = "10.1037/ccp0000019",

language = "English",

volume = "83",

pages = "796--807",

journal = "Journal of Consulting and Clinical Psychology",

issn = "0022-006X",

publisher = "American Psychological Association Inc.",

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Schmidt, U , Magill, N , Renwick, B , Keyes, A , Kenyon, M , Dejong, H , Lose, A , Broadbent, H, Loomes, R, Yasin, H, Watson, C, Ghelani, S, Bonin, E-M, Serpell, L, Richards, L, Johnson-Sabine, E, Boughton, N, Whitehead, L, Beecham, J, Treasure, J & Landau, S 2015, 'The Maudsley Outpatient Study of Treatments for Anorexia Nervosa and Related Conditions (MOSAIC): Comparison of the Maudsley Model of Anorexia Nervosa Treatment for Adults (MANTRA) With Specialist Supportive Clinical Management (SSCM) in Outpatients With Broadly Defined Anorexia Nervosa: A Randomized Controlled Trial', Journal of Consulting and Clinical Psychology, vol. 83, no. 4, pp. 796-807. https://doi.org/10.1037/ccp0000019

The Maudsley Outpatient Study of Treatments for Anorexia Nervosa and Related Conditions (MOSAIC): Comparison of the Maudsley Model of Anorexia Nervosa Treatment for Adults (MANTRA) With Specialist Supportive Clinical Management (SSCM) in Outpatients With Broadly Defined Anorexia Nervosa: A Randomized Controlled Trial. / Schmidt, Ulrike ; Magill, Nicholas ; Renwick, Bethany et al.
In: Journal of Consulting and Clinical Psychology, Vol. 83, No. 4, 08.2015, p. 796-807.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - The Maudsley Outpatient Study of Treatments for Anorexia Nervosa and Related Conditions (MOSAIC)

T2 - Comparison of the Maudsley Model of Anorexia Nervosa Treatment for Adults (MANTRA) With Specialist Supportive Clinical Management (SSCM) in Outpatients With Broadly Defined Anorexia Nervosa: A Randomized Controlled Trial

AU - Schmidt, Ulrike

AU - Magill, Nicholas

AU - Renwick, Bethany

AU - Keyes, Alexandra

AU - Kenyon, Martha

AU - Dejong, Hannah

AU - Lose, Anna

AU - Broadbent, Hannah

AU - Loomes, Rachel

AU - Yasin, Huma

AU - Watson, Charlotte

AU - Ghelani, Shreena

AU - Bonin, Eva-Maria

AU - Serpell, Lucy

AU - Richards, Lorna

AU - Johnson-Sabine, Eric

AU - Boughton, Nicky

AU - Whitehead, Linette

AU - Beecham, Jennifer

AU - Treasure, Janet

AU - Landau, Sabine

PY - 2015/8

Y1 - 2015/8

N2 - OBJECTIVE: Anorexia nervosa (AN) in adults has poor outcomes, and treatment evidence is limited. This study evaluated the efficacy and acceptability of a novel, targeted psychological therapy for AN (Maudsley Model of Anorexia Nervosa Treatment for Adults; MANTRA) compared with Specialist Supportive Clinical Management (SSCM).METHOD: One hundred forty-two outpatients with broadly defined AN (body mass index [BMI] ≤ 18.5 kg/m2) were randomly allocated to receive 20 to 30 weekly sessions (depending on clinical severity) plus add-ons (4 follow-up sessions, optional sessions with dietician and with carers) of MANTRA (n = 72) or SSCM (n = 70). Assessments were administered blind to treatment condition at baseline, 6 months, and 12 months after randomization. The primary outcome was BMI at 12 months. Secondary outcomes included eating disorders symptomatology, other psychopathology, neuro-cognitive and social cognition, and acceptability. Additional service utilization was also assessed. Outcomes were analyzed using linear mixed models.RESULTS: Both treatments resulted in significant improvements in BMI and reductions in eating disorders symptomatology, distress levels, and clinical impairment over time, with no statistically significant difference between groups at either 6 or 12 months. Improvements in neuro-cognitive and social-cognitive measures over time were less consistent. One SSCM patient died. Compared with SSCM, MANTRA patients rated their treatment as significantly more acceptable and credible at 12 months. There was no significant difference between groups in additional service consumption.CONCLUSIONS: Both treatments appear to have value as first-line outpatient interventions for patients with broadly defined AN. Longer term outcomes remain to be evaluated.

AB - OBJECTIVE: Anorexia nervosa (AN) in adults has poor outcomes, and treatment evidence is limited. This study evaluated the efficacy and acceptability of a novel, targeted psychological therapy for AN (Maudsley Model of Anorexia Nervosa Treatment for Adults; MANTRA) compared with Specialist Supportive Clinical Management (SSCM).METHOD: One hundred forty-two outpatients with broadly defined AN (body mass index [BMI] ≤ 18.5 kg/m2) were randomly allocated to receive 20 to 30 weekly sessions (depending on clinical severity) plus add-ons (4 follow-up sessions, optional sessions with dietician and with carers) of MANTRA (n = 72) or SSCM (n = 70). Assessments were administered blind to treatment condition at baseline, 6 months, and 12 months after randomization. The primary outcome was BMI at 12 months. Secondary outcomes included eating disorders symptomatology, other psychopathology, neuro-cognitive and social cognition, and acceptability. Additional service utilization was also assessed. Outcomes were analyzed using linear mixed models.RESULTS: Both treatments resulted in significant improvements in BMI and reductions in eating disorders symptomatology, distress levels, and clinical impairment over time, with no statistically significant difference between groups at either 6 or 12 months. Improvements in neuro-cognitive and social-cognitive measures over time were less consistent. One SSCM patient died. Compared with SSCM, MANTRA patients rated their treatment as significantly more acceptable and credible at 12 months. There was no significant difference between groups in additional service consumption.CONCLUSIONS: Both treatments appear to have value as first-line outpatient interventions for patients with broadly defined AN. Longer term outcomes remain to be evaluated.

U2 - 10.1037/ccp0000019

DO - 10.1037/ccp0000019

M3 - Article

C2 - 25984803

SN - 0022-006X

VL - 83

SP - 796

EP - 807

JO - Journal of Consulting and Clinical Psychology

JF - Journal of Consulting and Clinical Psychology

IS - 4

ER -

Schmidt U , Magill N , Renwick B , Keyes A , Kenyon M , Dejong H et al. The Maudsley Outpatient Study of Treatments for Anorexia Nervosa and Related Conditions (MOSAIC): Comparison of the Maudsley Model of Anorexia Nervosa Treatment for Adults (MANTRA) With Specialist Supportive Clinical Management (SSCM) in Outpatients With Broadly Defined Anorexia Nervosa: A Randomized Controlled Trial. Journal of Consulting and Clinical Psychology. 2015 Aug;83(4):796-807. doi: 10.1037/ccp0000019