Table 2 Characteristics of the 36 studies included in the Metasynthesis
From: Conceptualisation of severe and enduring anorexia nervosa: a qualitative meta-synthesis
Source Paper & Foci | Year | Country Setting | Sample: size (N), %Female(F) /male (m), mean age (M) and range (R) (years) | Illness duration (yrs), diagnosis (Dx)—self or method), author stipulation | Treatment Status (TS:Y/N sought treatment) Treatment Type (T), Description (D), number (N) | Recruitment | Data Analysis | CASP RATING *** = HIGH QUALITY |
|---|---|---|---|---|---|---|---|---|
Arkell & Robinson (P) | 2008 | UK | N = 11 F = 91% age = 37.7yrs |  > 10yrs, Dx ICD-10, SEED-AN | TS = Y (all) T,D,N unknown | Community treatment setting | ‘coding’ (Serpell 1999) | * |
Antoine et al. (P) | 2018 | France | N = 5, F = 100% age = 35ys (R = 29-46yrs) | M = 14.4y (R = 10-18yrs), Dx = U, chronic AN | Unknown | Clinical | IPA | *** |
Broomfield et al. (P) | 2021 | Australia | N = 11, F = 100%, age M = 41.6 (R = 29-66yrs) | M = 26.2yrs (R = 7-53yrs) Longstanding AN | TS = 10/11 | Community | Narrative TA | *** |
Blackburn & O’Çonnor (P & TE) | 2020 | Ireland | N = 6, F = 100%, age M = 39.4yrs (22-44yrs) | R = 8-28yrs, formal Dx, Longstanding AN | TS = All > 2 treatments, all = OP, 5/6 = IP | Community | Not specified | *** |
Chinello et al. (P) | 2019 | Italy | N = 5, F = 100%, age M = 46yrs (40-54yrs) | Dx = DSM-5, M = 29.2yrs (R = 23-37yrs) | n/a | Community | IPA | ** |
Cardi et al. (P) | 2018 | UK | N = 90, F = 97.8% | Dx = DSM-5, M = 8.4y, R = 0-46yrs | TS Y (all), 37% IP, 100% OP | Community | TA | * |
Dalton et al. (TE) | 2022 | UK | N = 15, | M = 15.05yrs, Dx = DSM-V, SE-AN | TS Y (all > 2prior treatments, M = 2.47, IP N = 2.31stays), rTMS | Clinical | Inductive—Elo and Kyngas (2008) | * |
Dawson, Rhodes & Adams (R) | 2014 | Australia | N = 8, F = 100%, R = 31-64yrs | M = 15.5yrs, R = 9-44yrs, Dx = DSM4 | TS 100% = Y, | Community | Narrative TA | *** |
Eivors et al. (TE) | 2003 | UK | N = 8, F = 100%, M = 25.75yrs, R = 21–43 yrs | M = 6.75, R = 3-20yrs | TS 100% = Y, IP = 50%, OP = 100% | Clinical | Social Constructivist GT | ** |
Espeset et al. (P) | 2012 | Norway | N = 14, M = 29.1yrs, R = 19-39yrs | M = 10yrs, Range 3-25yrs Dx = 100% DSM-4, | TS 100% = Y, IP = 57%, OP = 100% | Clinical | GT (Corbin and Stauss) | ** |
Fox & Diab (P) (TE) | 2015 | UK | N = 6, F = 100% Age M = 29.5yrs R = 19 to 50yrs | M = 7yrs, R = 6-23yrs. Dx = DSM-4, Chronic AN | TS = 100% > 2 psychological therapies | Clinical, Two eating disorder services | IPA | *** |
Foye et al. (P) | 2019 | UK | N = 5, F = 80% | R = 5-20yrs, Dx = 4/5 formally, SEED-AN | TS = 4/5, IP = 60%, OP = 80% | Clinical | TA | *** |
Hannon et al.(P) (TE) | 2017 | UK | N = 5 R = 23 -30 yrs, F = 100% | R = 4-11yrs, Dx 100% ICD 10, SE-AN | AN Intensive Treatment Team model: intensive community-based care (> 2years) | Clinical Treatment settings | IPA | *** |
Joyce et al. (P) (TE) | 2019 | UK | N = 8, F = 87.5%, M = 44yrs, R = 20-64yrs | R = 10-40yrs, SE-AN | TS 100% > 2, IP = 62.5%, OP = 100% | Clinical | NA | *** |
King-Murphy (P) | 1997 | Canada | N = 6, F = 100%, | M = 12.8yrs, R = 6-18y | TS = 100% > 2, IP = 67%, OP = 100% | Clinical | Van Mannen’s phenomenology | *** |
Kolnes (P) | 2016 | Norway | N = 6, F = 100%, M = 32.5y, R = 23-50yrs | M = 12.8yrs, R = 6-18yrs | TS = 100% Y, | Clinical residential | IPA | *** |
Kyriacou et al. (LE) | 2009 |  | N = 6 F = 100% M = 26.8yrs R-20-36yrs | M = 10.7yrs, R = 4-22yrs | TS 100% Y | Clinical | TA | ** |
Marchant & Payne (TE) | 2002 | UK | N = 5, F = 100%, R = 22-38yrs | R = 4-20yrs | TS = 100%, IP = 20%, OP = 100%, psychodynamic, Gestalt, CBT, PCT | Community | Heuristic (Moustakas 1990) | * |
Marzole et al. (P) | 2015 | Italy | N = 34, F = 100%, M = 25,6yrs, R = 18-40yrs | M = 9yrs, R = 4-14yrs, Dx 100% = DSM | Psychodynamic, DP | Clinical DP | Coding (Serpell, 1999) | * |
McCallum & Alaggia (P)(R) | 2021 | Canada | N = 19, F = 95%, M = 50.6yrs, R = 40-64yrs | M = 19.2yrs, R = 11-40yrs, | TS = 100% Y | Community | GT | *** |
Musolino et al. (P) | 2020 | Australia | N = 5, F = 100%, M = 25.8yrs, R = 27-52yrs | M = 18yrs, R = 10-30yrs, Dx formal (100%), SE-AN | TS = 100%Y | Community | GT | ** |
Lyons (P) | 2018 | UK | N = 7, F = 0%, M = 28yrs, R = 23-34Yrs | M = 11, R = 4-19yrs | TS = 100% Y, CBT, Schema, Psychodynamic, OT, Dietetics | Community | Narrative | *** |
Ostermann et al. (T) | 2019 | Germany | N = 1,(F), Age 38yrs, | Duration 30 years, | IP > 4, Yoga | Treatment sample | Not-specified | * |
Patching & Lawler ® | 2009 | Australia | N = 20, F = 100%, R = 24-52yrs | R = 4-17yrs, Dx formal = 55%, | formal treatment IP or OP = 55%, self-help = 45% | Community | Narrative TA | * |
Ramjan et al. (TE) | 2017 | Australia | N = 6, F = 100%,M = 26.8yrs, R = 18-38yrs | M = 5.4y, R = 1-10yrs (1 pt < 3yrs) Dx = Self report | Unknown | Community Treatment – Peer Support | TA | *** |
a. Rance st al. (R) | 2017 | UK | N = 12, F = 100%, M = 31.5yrs, R = 18-50yrs | M = 13.29yrs, R = 2-28yrs (91.6% > 4yrs) | CBT, Analytic, Psychodynamic, Integrative | Purposive community | TA | *** |
b. Rance et al. (TE) | 2017 | UK | As above | As Above | CBT, Analytic, Psychodynamic, Integrative | Purposive, Community | TA | *** |
Robinson et al. (P) | 2015 | UK | N = 7, F = 71.4%, M = 50yrs, R = 40-59yrs | M = 32.1yrs, R = 20-40yrs, Dx DSM5, SEED-AN | IP = 86%, OP >  × 2, | Clinical | TA | *** |
Ross & Green (P)(TE) | 2011 | UK | N = 2 Age: 18 + years F = 100% | Duration > 5yrs, Chronic AN | Psychodynamic inpatient treatment | Clinical (ED service) | Narrative TA | *** |
Strand et al. (P) (TE) | 2018 | Sweden | N = 16, F = 94%, M = 31Yrs, R = 18-56yrs | M = 15yrs, R = 3-42yrs, Dx DSM-5, | TS = 100Y Unspecified | Clinical | Inductive (unspecified) | *** |
Stockford et al. (P) (TE) | 2018 | UK | N = 6, F = 100%, M = 36yrs, R = 33-48yrs | M = 20.6yrs, R = 14-28yrs, Dx ICD-10 (all), SE-AN | TS = 100%Y | Clinical | IPA | *** |
Thoresen et al. (TE) | 2021 | Norway | N = 1 (F), Age = 23yrs | Duration 7yrs, Dx = formal | Symptom-focused treatments (7yrs) Psychodynamic (12 sessions) | Treatment setting | IPA | * |
Trondalen (TE) | 2003 | Norway | N = 1(F), Age = 26yrs, | Duration 6 yrs, | Prior treatments = Y, IP × 2, OP 2.5 yrs, Music Therapy | Treatment setting | Not Specified | ** |
Williams et al. (P) | 2016 | UK | N = 11, F = 100%, M = 28yrs, R = 18-60yrs | M = 13.5yrs, R = 5-48yrs, Dx = DSM5 (all), | Unknown | Community plus 2 ED clinics Theoretical sampling | GT | *** |
Wright & Hacking (TE) | 2012 | UK | N = 6, F = 100%, R = 21-44yrs | M = 11yrs, Dx formal | OP = 100%, treatment M = 11 years | Day care services, | Van Manen 1990 | * |