From Neurobiology to Psychological Interventions: Pathophysiological Mechanisms and Treatment Strategies for Anorexia Nervosa

AN is a kind of complex psychiatric disorder which are usually characterized by serious caloric restriction, underestimated body image, and strong fear of increasing weight. This review explores the multifactor behind AN both in terms of pathology and pathophysiology. Particularly, the abnormality of reward processing circuits is analyzed in detail considering neurobiological alterations which involve neurotransmitters, hormonal disruptions, and dysfunctions. All these internal disorders are also combined with psychological distortions including self-perfectionism and external social pressures that idolize body thinness. The paper also discusses advances in treatment strategies, developing from traditional psychological therapies to newly-born neuromodulation and gut-brain axis modulation. According to recent findings, it can be concluded that symptomatic treatments cannot effectively work without other assisting therapies in the neurobiological field and those distorted social concepts. In this way, mental health is predicted to be maintained for longer time if precisive, tailored and multi-level interventions are adopted. However, it has to be admitted that there are still huge gaps between the ideal theory and the reality. It remains unclear that how neurobiological factors interact and how they are affected by temporality. More seriously, most pharmacological treatments merely manage comorbidities while do not cure those core AN symptoms. In addition, treatment adherence and high relapse rates are another two main obstacles of long-term recovery.