| Abstract [eng] |
Anorexia nervosa has the highest mortality rate among psychiatric disorders. Therefore, significant attention is directed to improving diagnostics and treatment. Due to its complexity which requires a multidisciplinary approach, evidence-based strategies are essential to enhance outcomes. Aim. To analyze the most important clinical features of complex treatment of anorexia nervosa and to identify important treatment recommendations. Tasks. To analyze scientific literature on the complex treatment of anorexia nervosa. To identify and describe key clinical features of the complex treatment of anorexia nervosa based on the literature analysis. To analyze a clinical case focusing on the role of the mother-daughter relationship in the development and course of anorexia nervosa. To summarize the scientific literature and the clinical case analysis and to formulate recommendations relevant to the treatment of anorexia nervosa. Methods. A two-stage literature review was conducted. The first stage involved a preliminary overview to identify key clinical features of comprehensive treatment. In the second stage, an expanded literature analysis was performed using specific keywords in PubMed and Google Scholar. Full-text articles published 2015–2026, focusing on treatment characteristics of anorexia nervosa in children and adolescents (including retrospective studies) were included. In total, 127 articles were studied. Additionally, one clinical case was analyzed. Results. Treatment of anorexia nervosa requires a multidisciplinary approach. Its course is influenced by multiple etiopathogenetic and treatment-related factors. Key clinical aspects include fear of pubertal development and body changes, the role of mother-daughter relationship, comorbidity, refeeding challenges, long-term follow-up and the transition to adult psychiatric care. These factors may complicate treatment at any stage of the illness. Therefore, literature proposes preventive programs, diagnostic tools and treatment strategies. The case analysis highlights the importance of the mother-daughter relationship in the development and course of anorexia nervosa. Conclusions. Due to disorder’s complexity, including etiopathogenetic factors (fear of sexual maturation, mother-daughter relationship, comorbidity) and treatment related difficulties (refeeding, transition to adult psychiatry, long-term outcomes), the management remains challenging. Puberty is a critical risk factor, especially for early-maturing girls. Therefore, prevention should include sexual education, early diagnosis and psychotherapy. Mother-daughter relationship affects both the development of disorder and effectiveness of treatment. Comorbidity complicates diagnostics and management. The refeeding process has many potential complications and requires appropriate strategy. Long-term follow-up is essential, although guidelines are limited. Transition to adult care remains a vulnerable stage – structured, collaborative care planning is needed. |
