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Anorexia nervosa with comorbid severe depression: a systematic scoping review of brain stimulation treatments
Department of Clinical Neuroscience/Psychology, Karolinska Institute, Stockholm, Sweden; Center for Clinical Research Dalarna, Uppsala University, Falun, Sweden.
Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry. Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden.
Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden; Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Karolinska University Hospital, Region Stockholm, Stockholm, Sweden; Stockholm Health Care Services, Karolinska University Hospital, Region Stockholm, Sweden.
Stockholm Health Care Services, Region Stockholm, Karolinska University Hospital.
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2023 (English)In: Journal of ECT, ISSN 1095-0680, E-ISSN 1533-4112, Vol. 39, no 4, p. 227-234Article in journal (Refereed) Published
Abstract [en]

Major depressive disorder (MDD) is highly prevalent in individuals with anorexia nervosa (AN) and is a predictor of greater clinical severity. However, there is a limited amount of evidence supporting the use of psychotropic medications for its management. A systematic scoping review was conducted to assess the current literature on brain stimulation treatments for AN with comorbid MDD, with a specific focus on MDD treatment response and weight restoration. This review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, and the PubMed, PsycInfo, and MEDLINE databases were searched until July 2022 using specific key words related to AN and brain stimulation treatments. A total of 373 citations were identified, and 49 treatment studies that met the inclusion criteria were included in the review. The initial evidence suggests that electroconvulsive therapy, repetitive transcranial magnetic stimulation, and deep-brain stimulation may be effective in managing comorbid MDD in AN. Emerging evidence suggests that transcranial direct current stimulation may have a positive effect on body mass index in individuals with severe to extreme AN. However, there is a need for the development of better measurement techniques for assessing the severity of depression in the context of AN. Controlled trials that are adequately designed to account for these limitations are highly warranted for deep-brain stimulation, electroconvulsive therapy, and repetitive transcranial magnetic stimulation and hold promise for providing clinically meaningful results.

Place, publisher, year, edition, pages
Lippincott Williams & Wilkins, 2023. Vol. 39, no 4, p. 227-234
Keywords [en]
DBS, ECT, inpatients, MDD, severe anorexia nervosa, treatment guidelines
National Category
Psychiatry
Identifiers
URN: urn:nbn:se:umu:diva-218470DOI: 10.1097/YCT.0000000000000922ISI: 001185828800005PubMedID: 37053429Scopus ID: 2-s2.0-85178497245OAI: oai:DiVA.org:umu-218470DiVA, id: diva2:1821420
Funder
Region StockholmSwedish Research CouncilRegion VästerbottenAvailable from: 2023-12-20 Created: 2023-12-20 Last updated: 2025-04-24Bibliographically approved

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Jamshidi, EsmailSjögren, MagnusJokinen, JussiBoström, Adrian Desai E.

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