Ulrich Voderholzer

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Verified

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• Professor
• Medical Director at Schön Klinik Roseneck

Objective Although childhood maltreatment, especially emotional abuse, is strongly linked to the psychopathology of anorexia nervosa (AN), the impact of such a traumatic experience on treatment outcome is not clear. This study aimed to explore how emotional abuse affects change in psychopathology during treatment. Method Adolescents with AN (n = 3...

Anorexia nervosa (AN) is a severe psychiatric disorder with the highest mortality rate among eating disorders. It predominantly affects adolescents and young adults, with a significant increase in prevalence among adolescents observed since the coronavirus disease 2019 (COVID-19) pandemic. It is frequently associated with other psychiatric disorder...

Signals from the body’s interior undergo several interoceptive processing steps, from the periphery to the central nervous system, to conscious recognition and evaluation. Alterations in some of these steps have been reported for eating and weight disorders, but systematic comparisons between steps and disorders are necessary to develop targeted in...

Background Eating disorders (EDs) are severe psychiatric conditions, with prevalence rates ranging from 5.5 to 17.9% in women and 0.6 to 2.4% in men. EDs carry a high risk of chronicity and mortality, highlighting the need for effective prevention strategies. Primary prevention can target the entire population (universal), high-risk groups (selecti...

Anorexia nervosa (AN) is a severe psychiatric disorder with the highest mortality rate among eating disorders. It predominantly affects adolescents and young adults, with a significant increase in prevalence among adolescents observed since the coronavirus disease 2019 (COVID-19) pandemic. It is frequently associated with other psychiatric disorder...

Objective: Persons with bulimia nervosa (BN) often gain weight during treatment, which potentially poses a threat to treatment adherence. Although weight suppression has been found to be a predictor of weight gain in persons with BN, research about the trajectory of weight changes during treatment and other predictors thereof is scarce. Method: The...

Theoretischer Hintergrund: Emetophobie bezeichnet die Angst, dass man selbst oder andere Personen erbrechen könnten und wird als spezifische Phobie in den aktuellen, diagnostischen Klassifikationssystemen geführt. Es handelt sich aber um eine relativ unbekannte und wenig untersuchte psychische Störung. In der Literatur wird spekuliert, dass sich Em...

Anorexia nervosa, bulimia nervosa and binge-eating disorder are severe mental illnesses and are often associated with mental comorbidities, such as depression, anxiety and obsessive-compulsive disorders. Psychotherapy is considered the primary method of treatment; however, in the clinical practice it is not uncommon to also use psychopharmacotherap...

Emotions and eating bidirectionally influence each other in eating disorders, contributing to the observed symptomatology. Network modelling can reveal these relationships, but it has rarely been conducted with prospective, naturalistic data. We explored networks looking at prospective relationships between negative and positive emotions on one han...

Objective In the Diagnostic and Statistical Manual of Mental Disorders‐5, severity of bulimia nervosa (BN) is defined by the frequency of purging behaviour. Previous research suggests the number of purging methods as an alternative rating. The current analysis investigated characteristics (sociodemographic and treatment‐related variables, body mass...

Background Bulimia nervosa (BN) is a serious mental illness with impulsivity as a cardinal symptom. Impulsivity contributes to various other, often comorbid, mental disorders, such as attention deficit/hyperactivity disorder (ADHD) and borderline personality disorder (BPD). The aim of this study was to explore comorbidities of BN with ADHD and BPD...

Driven exercise is a transdiagnostic maladaptive behavior, especially common in eating disorders (EDs); however, its maintenance mechanisms remain poorly understood. To address this gap, we examined the applicability of previously empirically derived and validated reinforcement-function models in explaining driven-exercise maintenance in studies va...

Introduction Although depressive disorders are frequently associated with relapses, the sustained efficacy of therapies after their termination has been insufficiently investigated. Objective The aim of this study was to evaluate the current evidence of enduring effects of psychotherapy, antidepressants and their combination after the end of treat...

Introduction The impact of antipsychotic use on weight gain and eating disorder-related psychopathology in adult inpatients with anorexia nervosa (AN) is unclear. Methods Consecutively hospitalized adults with AN were retrospectively analyzed. Co-primary outcomes were body mass index (BMI) and weekly weight change. Secondary outcomes were Eating Di...

Objective It is often stated that a higher body mass index (BMI) at the beginning of treatment predicts a better weight outcome at the end of treatment in persons with anorexia nervosa (AN). However, this interpretation is based on the between‐persons relationship of BMI at the two measurements, which primarily reflects the fact that the rank‐order...

Objective: Patients with bulimia nervosa (BN) often gain weight during treatment, which potentially poses a threat to treatment adherence. Although weight suppression has been found to be a predictor of weight gain in persons with BN, research about the nature of weight changes during treatment and other predictors thereof is scarce. Method: The cu...

Objective: Patients with bulimia nervosa (BN) often gain weight during treatment, which potentially poses a threat to treatment adherence. Although weight suppression has been found to be a predictor of weight gain in persons with BN, research about the nature of weight changes during treatment and other predictors thereof is scarce.Method: The cur...

Compulsive exercise is a commonly observed behavior in persons with anorexia nervosa (AN). Studies with rodents and persons with AN suggest that semistarvation-induced, higher physical activity is linked to lower leptin levels and can be reduced by leptin administration. However, findings have been inconsistent and, thus, the link between leptin an...

The Brief Resilience Scale (BRS) was developed to assess individual differences in the ability to recover from stress despite adversity and has been translated into several languages. This study aimed to examine the psychometric properties (i.e., item characteristics, reliability, factor structure, measurement invariance, and validity) of the Germa...

Objective Assessment of the longer‐term outcome of anorexia nervosa (AN) in female adolescent inpatients (N = 132). Method A follow‐up (mean 8.2 years) after treatment was conducted. A subsample of 39 patients with at least 10 years of follow‐up (mean 14 years) was defined. Results Over the 8‐year follow‐up period, the body mass index (BMI) incre...

Purpose Emotional eating during negative emotions might underlie disordered eating behavior (i.e., binge eating and food restriction). Positive emotions, by contrast, seem to promote healthier eating behavior. Naturalistic research on the links between emotions and eating across individuals with binge-eating disorder (BED), bulimia nervosa (BN), bi...

We previously found that rumination maintains obsessive–compulsive (OC) symptoms. Our goal was to explore the moderating roles of three characteristics in the immediate and intermediate effects of rumination on OC symptoms: trait rumination, severity of comorbid depressive symptoms, and the tendency to misinterpret the occurrence of unwanted intrus...

Emetophobia refers to a fear that oneself or others might vomit and is classified as a specific phobia in current diagnostic manuals. However, it is a relatively unknown and understudied mental disorder. Although it has been speculated that emetophobia might differ from other specific phobias (e.g., in terms of severity), studies on this are virtua...

Objective: It is often stated that higher body mass index (BMI) at the beginning of treatment predicts a better outcome at the end of treatment in persons with anorexia nervosa (AN). However, this interpretation is based on the between-persons relationship of BMI at the two measurements, which primarily reflects the fact that the rank-ordering of p...

Objective: The Eating Disorder Examination–Questionnaire (EDE–Q) is one of the most widely used self-report measures for the assessment of eating disorder (ED) symptomatology. However, proposed cut-off scores that may indicate the presence of an ED have been heterogeneous. Therefore, the current study derived cut-off scores from two large samples:...

Background Some persons with obsessive–compulsive disorder (OCD) refuse or drop out of treatment because of the aversive nature of exposure and response prevention therapy when they have to face and tolerate unpleasant thoughts, emotions, and bodily sensations. Indeed, one study suggested that a higher willingness to experience unpleasant thoughts,...

Background: The variation in body mass index (BMI) of inpatients with anorexia nervosa has not been analyzed across the age span. A positive correlation between BMI and age has been reported in adolescent inpatients aged 15 years and younger that levels off at 15 to 18 years. BMIs standardized for age and sex (standard deviation scores, SDSs) were...

Child maltreatment is a risk factor for mental disorders and decreased life satisfaction during adolescence. We investigated whether child maltreatment would link to life satisfaction both directly and through psychological symptoms, whether these relations would change from admission to discharge after treatment, and which types of maltreatment, s...

Eating disorders (EDs), especially anorexia nervosa and bulimia nervosa, are associated with medical complications that may require treatment in hospital. Such presentations could be due to malnutrition, consequences of refeeding, or ED behavior complications, particularly purging. Complications may constitute medical emergencies at presentation or...

Background: Therapist-guided exposure and response prevention (ERP) for the treatment of obsessive-compulsive disorder (OCD) is frequently conducted within clinical settings but rarely at places where patients are usually confronted with OCD symptom-provoking situations in daily life (eg, at home). Objective: This study aimed to investigate patient...

Obsessive-compulsive disorders (OCD) are mainly treated with disorder-specific cognitive behavioral therapy using exposure and response management and/or selective serotonin reuptake inhibitors; however, a significant subgroup of patients does not sufficiently benefit from this approach. This article provides an overview of treatment-resistant OCD....

Introduction Cognitive behaviour therapy with exposure and response prevention is efficient in treating patients with obsessive-compulsive disorder (OCD). Nevertheless, it would be helpful for many patients to complement the therapeutic treatment with acceptance strategies to further increase the therapeutic benefit. The aim of the present study wa...

Persons with obsessive–compulsive disorder (OCD) are often impaired in their daily level of functioning due to their time-consuming obsessions and/or compulsions. To date, however, studies are lacking that quantify how much time persons with OCD actually spend on activities of daily living. Therefore, the current study assessed 13 daily life activi...

Objective The Eating Disorder Examination‐Questionnaire (EDE‐Q) is one of the most widely used self‐report measures for the assessment of eating disorder (ED) symptomatology. However, proposed cutoff scores that may indicate the presence of an ED have been heterogeneous. Therefore, the current study derived cutoff scores from two large samples: one...

Objective Although inpatient treatment is highly effective for patients with bulimia nervosa (BN), some patients show a resurgence of symptoms and relapse after discharge. Therefore, the aim of this study is to evaluate the efficacy of a guided smartphone‐based aftercare intervention following inpatient treatment to support recovery. Method 172 fe...

Background Resilience—the ability to bounce back or quickly recover from stress—has been found to predict treatment outcome in patients with mental disorders such as depression. The current study aimed to test whether resilience itself changes during treatment and whether resilience exclusively predicts changes in depressive symptoms or whether dep...

Background Depression is one of the most prevalent mental disorders and frequently co-occurs with other mental disorders. Despite the high direct and indirect costs to both individuals and society, more than 80% of those diagnosed with depression remain with their primary care physician and do not receive specialized treatment. Self-guided digital...

Introduction The duration of untreated illness (DUI), that is, the interval between the onset of anorexia nervosa (AN) symptoms and start of specialized treatments, has a strong influence on the prognosis. Objective To quantify modifiable predictors of the DUI and to derive recommendations for secondary prevention strategies. Methods Within a mul...

Anorexia nervosa is an illness affecting primarily adolescent girls and young women. Clinical guidelines recommend early intervention, with inpatient treatment for more severe cases. We present an evaluation of a multi-modal cognitive–behavioral inpatient treatment (CBT-E) involving carers in specialized units for adolescents. Routine data of 962 a...

BACKGROUND Therapist-guided exposure and response prevention (ERP) for the treatment of obsessive-compulsive disorder (OCD) is frequently conducted within clinical settings but rarely at places where patients are usually confronted with OCD symptom-provoking situations in daily life (eg, at home). OBJECTIVE This study aimed to investigate patients...

Einleitung: Eine stationäre Behandlung führt zu einer starken Gewichtszunahme sowie zu einer starken Abnahme der Essstörungsymptomatik und weiteren psychopathologischen Aspekten bei PatientInnen mit Anorexia nervosa (AN). Insbesondere innerhalb des ersten Jahres nach Entlassung sind die Rückfallraten allerdings hoch. Methoden: Die vorliegende Unter...

Einleitung: Sowohl für die Anorexia nervosa (AN) als auch für die Bulimia nervosa (BN) finden sich in der S3-Leitlinie Empfehlungen zu tagesklinischer Behandlung. Das tagesklinische Setting bietet durch die hohe Alltagsnähe einerseits therapeutische Chancen, andererseits bringt es auch Limitationen mit Blick den behandelbaren Schweregrad mit sich....

Objective Food‐cue‐reactivity entails neural and experiential responses to the sight and smell of attractive foods. Negative emotions can modulate such cue‐reactivity and this might be central to the balance between restrictive versus bulimic symptomatology in Anorexia Nervosa (AN) and Bulimia Nervosa (BN). Method Pleasantness ratings and electroc...

Unlabelled: Anorexia nervosa is associated with a significant risk of morbidity and mortality. In clinical practice, health risk is assessed and estimated using routinely collected laboratory data. This study will develop a risk score using clinically relevant laboratory parameters. The related question is how to estimate the health risk associate...

Background and objectives: Preliminary findings suggest that Acceptance and Commitment Therapy-informed exposure therapy may be an effective treatment for obsessive–compulsive disorder (OCD). However, there is a lack of experimental studies that have examined immediate effects of acceptance-based strategies during exposure to disorder-relevant stim...

Therapist-guided exposure and response prevention (ERP) for the treatment of obsessive-compulsive disorder (OCD) is frequently conducted within clinical settings but rarely at places where patients are usually confronted with OCD symptom-provoking situations in daily life (e.g., at home). Therefore, the aim of this study was to investigate patients...

Objective: This study explored the association between Childhood maltreatment (CM) experiences and life satisfaction in adolescents with eating disorders (EDs). Methods: Adolescent inpatients with EDs completed the Childhood Trauma Questionnaire, the Satisfaction With Life Scale, the Brief Symptom Inventory and the Eating Disorder Inventory-2 at...

Objective The new ICD‐11 eating disorders (ED) guidelines are similar to the DSM‐5 criteria. One difference to the DSM‐5 is the inclusion of subjective binges in the definition of bulimia nervosa (BN) and binge‐eating disorder (BED). The aim of this study was to identify differences between the ICD‐11 guidelines and DSM‐5 ED criteria, which could i...

Anorexia nervosa (AN) is marked by a high rate of comorbid depression, which raises the question whether depressive symptoms may adversely affect treatment outcome. Thus, we examined whether depressive symptoms at admission would predict weight change from admission to discharge in a large sample of inpatients with AN. In addition, we also explored...

Weight suppression refers to the difference between a person’s current and highest body weight at their current height. Higher weight suppression has been found to predict larger weight gain in both non-clinical samples and patients with eating disorders but little is known about possible mechanisms that mediate this effect. In the current study, w...

Objective: Anorexia nervosa (AN) is marked by a high rate of comorbid depression, which raises the question whether depressive symptoms may adversely affect treatment outcome. Thus, we examined whether depressive symptoms at admission would predict weight change from admission to discharge in a large sample of inpatients with AN. In addition, we al...

It has been widely assumed that longer illness duration predicts poorer treatment outcome in persons with anorexia nervosa (AN). However, studies on the prognostic effects of illness duration have produced mixed results. Thus, the aim of the current study was to examine the relationship between illness duration and short-term treatment outcome in a...