Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Aug 18;13(1):178.
doi: 10.1186/s40337-025-01352-5.

"We went fishing in the dark": a case report highlighting one therapeutic process in an out-patient comorbid anorexia nervosa (AN) and complex post-traumatic stress disorder (C-PTSD) treatment

Kathrine Rasch Moyo  1 , Barbara Juliana Stenvall  2 , Berit Støre Brinchmann  3
Affiliations

"We went fishing in the dark": a case report highlighting one therapeutic process in an out-patient comorbid anorexia nervosa (AN) and complex post-traumatic stress disorder (C-PTSD) treatment

Kathrine Rasch Moyo et al. J Eat Disord. .

Abstract

Background: There has been little research into effective treatment of comorbid AN and C-PTSD. This group of patients may show severe and enduring illness histories, often needing repeated hospitalisation and periods of outpatient treatment, adversely affecting their lives. Presently, there is no single recommended treatment for patients with comorbid AN and C-PTSD.

Case presentation: This article presents a case report of one therapeutic process through two stories; the patient's and the therapist's. The therapeutic approach in this case of comorbid AN and C-PTSD was symptomatic-, person- and process-oriented, with an eclectic choice of therapeutic methods including enhanced cognitive behavioural therapy for eating disorders (EDs) (CBT-E), mentalisation based therapy for EDs (MBT-ED), compassion focused therapy for EDs (CFT-E), emotionally focused therapy (EFT), and narrative exposure therapy (NET), aiming to provide personalised care; tailoring the interventions to the patient. The therapeutic relationship and treatment are analysed, with the aim of highlighting what influenced the therapeutic process.

Conclusion: The authors are not aware of other studies addressing the stories of patient and therapist in a therapeutic relationship, used to better understand factors relevant to the therapeutic process, in treating comorbid AN and C-PTSD. This case report provides insight into one therapeutic process treating these psychiatric illnesses in combination. The overall goal in therapy proved to be minimising the distances within the patient, between patient and therapist, between patient and society, and between the patient's past and present, through a personalised approach. Further research should elaborate on the dyadic perspective unfolding from these two stories; addressing specifically the emotional-relational processes within the therapeutic relationship, to help broaden the understanding of treatment for comorbid AN and C-PTSD. We call for further research into personalised therapeutic interventions for these patients, suggesting a 'toolkit' of interventions, tailored to the patient. It should not be the patient's job to fit the method, but our job to make sure the method fits the patient.

Keywords: Anorexia nervosa; Case report; Complex PTSD; Eating disorders; Personalised care.

PubMed Disclaimer

Conflict of interest statement

Declarations. Ethics approval and consent to participate: The project was considered not required to be submitted by the Regional Committee of Medical and Health Research Ethics (REK). It is approved by the data protection officer at the Nordland Hospital Trust. For the record, the patient provided a written consent to have the article published in full. Consent for publication: As a co-author of this case report, the patient provided consent to have the article published in full. Competing interests: The authors declare no competing interests.

Similar articles

See all similar articles

References

    1. Keski-Rahkonen A, Mustelin L. Epidemiology of eating disorders in Europe: prevalence, incidence, comorbidity, course, consequences, and risk factors. Curr Opin Psychiatry. 2016;29(6):340-5. 10.1097/YCO.0000000000000278. PMID: 27662598. - PubMed
    1. Smink FR, van Hoeken D, Hoek HW. Epidemiology of eating disorders: incidence, prevalence and mortality rates. Curr Psychiatry Rep. 2012;14:406–14. 10.1007/s11920-012-0282-y - PMC - PubMed
    1. Dejong H, Broadbent H, Schmidt U. A systematic review of dropout from treatment in outpatients with anorexia nervosa. Int J Eat Disord. 2012;45(5):635–47. 10.1002/eat.20956. Epub 2011 Aug 30. PMID: 22684990. - PubMed
    1. Marzola E, Longo P, Sardella F, Delsedime N, Abbate-Daga G. Rehospitalization and revolving door in anorexia nervosa: are there any predictors of time to readmission?? Front Psychiatry. 2021;12:694223. 10.3389/fpsyt.2021.694223. PMID: 34366923; PMCID: PMC8342847. - PMC - PubMed
    1. Herpertz S, Hagenah U, Vocks S, von Wietersheim J, Cuntz U, Zeeck A. German society of psychosomatic medicine and psychotherapy; German college for psychosomatic medicine. The diagnosis and treatment of eating disorders. Dtsch Arztebl Int. 2011;108(40):678–85. 10.3238/arztebl.2011.0678. Epub 2011 Oct 7. PMID: 22114627; PMCID: PMC3221424. - PMC - PubMed

LinkOut - more resources