Date of Award


Degree Type

Selective Evidence-Based Medicine Review

Degree Name

Master of Science in Health Sciences - Physician Assistant


Physician Assistant Studies


OBJECTIVE: The objective of this selective EBM review is to determine whether or not “Does the use of intranasal oxytocin in the treatment of women with anorexia nervosa improve recognition of emotional expression compared to placebo?”

STUDY DESIGN: A systematic review of three studies that were published in English between 2014-2018.

DATA SOURCES: Three randomized controlled trials (RCTs), two with a crossover design, that were published in peer-reviewed journals and found via PubMed. Articles were chosen based on pertinence to the clinical question.

OUTCOMES MEASURED: Improvement in the ability to recognize facial expressions were measured through the Reading the Mind in the Eyes Test (RMET) and attentional bias scores from a visual probe test. Images for the visual probe test were gathered from the Korean Facial Expressions of Emotion collection.

RESULTS: Kim et al. conducted a cross-over designed study that found increased vigilance to anger during administration of intranasal oxytocin. The calculated t-score was -2.847 (df = 30). This calculation is statistically significant with a p-value of 0.008. A study performed by Leppanen et al. found a mean change 土 standard deviation in accuracy on RMET as 78.83 土 13.74 for women using a placebo. The change with regards to the intranasal oxytocin spray was 81.77 土 10.67. This study did not include a calculation for statistical significance. Russell et al. found in an RCT that the mean change in accuracy in performance on the RMET was of 1.6 土3.1 in the placebo group as contrasted to 0.1 土2.0 in the experimental group. This study also failed to provide a statistical significance calculation.

CONCLUSION: Evidence presented in this review was inconclusive at determining whether intranasal oxytocin was effective at improving emotional recognition in women with anorexia nervosa. Statistical significance with a large treatment effect was shown in the study by Kim et al. in regards to increased vigilance of an angry expression. The studies by Leppanen et al. and Russell et al. did not provide a measure of statistical significance. Further research is needed to determine efficacy of intranasal oxytocin.