Publications by authors named "Stephen Touyz"

Background: Access to evidence-based treatments such as family-based therapy (FBT) is difficult for adolescents diagnosed with Anorexia Nervosa (AN) living in rural or regional areas due to a limited trained workforce, high staff turnover and inconsistent treatment fidelity. Telehealth offers a potential access solution by facilitating care irrespective of family or service location. The disruption to the health system caused by COVID-19 amplified an existing need and increased the use of telehealth to deliver FBT before its efficacy and safety was fully evaluated.

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Objective: This systematic review aims to comprehensively examine up-to-date evidence on the economic burden of eating disorders (EDs), both globally and by region.

Methodology: A comprehensive search within five electronic databases, MEDLINE, Embase, CINAHL, PsycINFO, and EconLit, retrieved studies published from August 1, 2013, to June 30, 2024. Cost of illness (COI) studies, burden of disease, and other cost studies that reported costs in monetary values were included, and cost-effectiveness analysis studies were excluded.

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Recent trials have shown promising results for the use of psychedelic-assisted therapies in treating severe refractory psychiatric illnesses, and there has been growing interest in examining the effectiveness of these therapies in treating eating disorders. To move forward in a safe, ethically sound, and scientifically rigorous manner, the field must address critical considerations. In this Comment article, we outline important risks and ethical considerations, along with methodological aspects that require careful consideration in the design of psychedelic-assisted therapy trials.

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Purpose: Developing personal goals beyond weight and shape, and promoting the agency to pursue those goals, could aid in treatment and recovery from anorexia nervosa (AN). This research explores the strengths, interests and goals of individuals currently receiving treatment for AN and evaluates how treatment services are supporting them to work towards personal goals across all areas of everyday life.

Method: A total of 58 community-dwelling adults currently receiving treatment for anorexia nervosa at any stage of recovery completed the Client Assessment of Strengths, Interests and Goals Self-Report (CASIG-SR).

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Dieting is a potent risk factor for eating disorder (ED) symptoms and development, which typically occur in late adolescence. However, as diets are often motivated by body image concerns (another core ED risk factor), dieters may already carry heightened ED risk. Thus, the current study aimed to document ED risk among young people starting a diet in the community.

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Background: Lisdexamfetamine dimesylate (LDX) has demonstrated safety and efficacy for treatment of Binge Eating Disorder (BED). However, to date, trials have not included participants with co-occurring psychiatric disorders. This study explores how LDX affects eating disorder psychopathology, symptoms of common psychiatric comorbidities of BED (ADHD, depression, anxiety), and psychological quality of life, in people with moderate to severe BED.

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Background: Speculation exists as to whether lisdexamfetamine dimesylate (LDX) acts on the functional connectivity (FC) of brain networks that modulate appetite, reward, or inhibitory control in binge-eating disorder (BED). Better insights into its action may help guide the development of more targeted therapeutics and identify who will benefit most from this medication. Here, we use a comprehensive data-driven approach to investigate the brain FC changes that underlie the therapeutic action of LDX in patients with BED.

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Background: Exploration of client identity negotiations during treatment for Anorexia Nervosa (AN) is a relatively new area of research. Research suggests that difficulties with identity negotiations may present as a barrier to treatment. This study sought to explore individuals' identity negotiations during therapy sessions using Compulsive Exercise Activity Therapy (LEAP) combined with Cognitive Behaviour Therapy for Anorexia Nervosa (CBT-AN).

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Article Synopsis
  • - The study aimed to compare the prevalence and impact of Bulimia Nervosa (BN), Binge Eating Disorder (BED), and Other Specified Feeding or Eating Disorder (OSFED) using DSM-5 versus ICD-11 criteria in a general population in South Australia.
  • - A total of 2,977 individuals aged 15 and older were interviewed about their eating disorder symptoms, sociodemographic features, and quality of life.
  • - Results indicated that the prevalence of BED was lower using DSM-5 criteria due to stricter binge-eating specifications, with no significant differences in demographics or health impacts between the two diagnostic systems.
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Introduction: Compulsive exercise is a transdiagnostic feature of eating disorders which adversely affects aspects of recovery, such as length of hospitalisation, risk of a chronic outcome, and risk of relapse. CompuLsive Exercise Activity TheraPy (LEAP) aims to reduce compulsive exercise through a cognitive behavioural approach. This study aims to investigate the effect of LEAP on compulsive exercise behaviour using subscales of the Compulsive Exercise Test (CET), a measure of exercise in individuals with eating disorders.

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Background: Psychotherapy is considered central to the effective treatment of eating disorders-focusing on behavioural, psychological, and social factors that contribute to the illness. Research indicates psychotherapeutic interventions out-perform placebo, waitlist, and/or other treatments; but, outcomes vary with room for major improvement. Thus, this review aims to (1) establish and consolidate knowledge on efficacious eating disorder psychotherapies; (2) highlight select emerging psychotherapeutic interventions; and (3) identify knowledge gaps to better inform future treatment research and development.

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Background: Night eating syndrome (NES) is a unique eating disorder characterised by evening hyperphagia and nocturnal ingestions which cause significant distress and/or impairment in functioning. Despite the growing literature, NES remains poorly understood and under diagnosed. As such, this study aims to compare the prevalence of physical health conditions in participants with NES when compared to participants without an eating disorder (ED) and participants with other eating disorders (including anorexia nervosa (AN), binge eating disorder (BED) and bulimia nervosa (BN)) in a general population Australian sample of adults.

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Anorexia nervosa (AN) is a mental health disorder that has serious physical, emotional and social consequences. Whilst cognitive behavioural therapy for AN (CBT-AN) has demonstrated efficacy, there remains a global need to improve AN treatment. Compulsive exercise activity therapy (LEAP) is an active therapy consisting of the addition to CBT-AN of eight specific sessions that focus on exercise and motivation for behavioural change.

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Background: Anorexia nervosa is a psychological condition characterised by self-starvation and fear or wait gain or other body image disturbance. The first line of treatment is specific psychological therapy; however, there is no consensus on best practice for treating people who develop severe and enduring anorexia nervosa (SEAN). Notably, there is no universal definition of SEAN.

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Introduction: Disordered eating among adolescents is of increasing concern given associated physical and mental health sequelae. Cognitions underlying disordered eating are formed in childhood and adolescence. Parents are a significant presence during this period, so it is critical to understand how they influence their adolescent's eating cognitions and behaviors.

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Purpose: The Wisconsin Card Sorting Test (WCST) is the most common measure of cognitive flexibility in anorexia nervosa (AN), but task-switching paradigms are beginning to be utilized. The current study directly compared performance on a cued task-switching measure and the WCST to evaluate their association in participants with a lifetime diagnosis of AN, and to assess which measure is more strongly associated with clinical symptoms.

Methods: Forty-five women with a lifetime diagnosis of AN completed the WCST, cued color-shape task-switching paradigm, Anti-saccade Keyboard Task, Running Memory Span, Eating Disorder Examination Questionnaire, Depression Anxiety Stress Scales short form and Eating Disorder Flexibility Index.

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Background: The current review broadly summarises the evidence base for pharmacotherapies and adjunctive and alternative therapies in the treatment of eating disorders and disordered eating.

Methods: This paper forms part of a Rapid Review series examining the evidence base in the field of eating disorders. This was conducted to inform the Australian National Eating Disorder Research and Translation Strategy 2021-2030.

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Background: Having reliable information to make decisions about the allocation of healthcare resources is needed to improve well-being and quality-of-life of individuals with eating disorders (EDs). EDs are a main concern for healthcare administrators globally, particularly due to the severity of health effects, urgent and complex healthcare needs, and relatively high and long-term healthcare costs. A rigorous assessment of up-to-date health economic evidence on interventions for EDs is essential for informing decision-making in this area.

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