August 2009  << Back  

Anorexia nervosa treatment from the patient perspective: A metasynthesis of qualitative studies

Cybele Ribeiro Espíndola, MSci

Department of Psychiatry, Federal University of São Paulo/UNIFESP, São Paulo, Brazil

Sergio Luís Blay, MD, PhD

Department of Psychiatry, Federal University of São Paulo/UNIFESP, São Paulo, Brazil

BACKGROUND: Anorexia nervosa is a complex condition that brings great challenges at each stage of treatment. This study aims to organize the body of information available in qualitative studies about the treatment of anorexia nervosa through a systematic literature review and metasynthesis.

METHODS: Searches were carried out on the following databases for the years 1990 to 2005: PubMed, ISI, PsycINFO, EMBASE, LILACS, and SciELO from 1990 to 2005. A meta-ethnographic approach was used to synthesize the data through second-order and third-order interpretations.

RESULTS: The search revealed 3415 studies, of which 16 were selected. Two concepts for second-order interpretation emerged from the process: (1) the process of change (phases of recovery, factors favoring recovery, factors limiting recovery) and (2) perception of the treatment modalities. From the second-order categories, a third-order category was derived—reconciliation, in which personal and environmental acceptance have a central role.

CONCLUSIONS: Recovery from anorexia nervosa, as a very complex process, goes well beyond conventional treatment. Self-acceptance, determination, and spirituality are equally important elements.

KEYWORDS: anorexia nervosa, treatment, systematic review, metasynthesis


CORRESPONDENCE: Sergio L. Blay, MD, PhD Department of Psychiatry Escola Paulista de Medicina-UNIFESP R. Botucatu, 740 CEP 04023-900 São Paulo SP Brazil. E-MAIL:
Annals of Clinical Psychiatry ©2009 American Academy of Clinical Psychiatrists

Read full article