Purpose -The purpose of this paper is to assess the effectiveness o f day treatment programmes for adults with eating disorders by comparing, evaluating and synthesizing published pre-and post-treatment outcomes. Design/methodology/approach -A systematic review was undertaken of publications containing quantitative outcome data relating to weight restoration among underweight patients, reduction in binge and purge/vomit symptoms, decrease in eating disorder psychopathology and improvement in psychological functioning. Findings -This systematic review o f pre-and post-treatment outcomes from 15 studies revealed large effect sizes relating to increase in Body Mass Index (BMI), reduction in symptoms and decrease in depression. Medium effect sizes were observed for improvement in self-esteem and reduction in anxiety and medium-large effect sizes were generally observed for attitude-change, although a small effect size was identified for perfectionism. Practical implications -This systematic review indicates that day treatment for adults is effective inincreasing BMI among underweight patients, reducing binge, purge/vomit symptoms and eating disorder psychopathology and improving psychological functioning. Further research is required to investigate whether gains are cost-effective and sustainable over the longer term, and how day treatment programmes can improve outcomes for patients who are vulnerable to non-response and drop-out. Originality/value To date, reviews o f day treatment for adults with eating disorders have focused upon comparisons o f treatment approach and structure and neglected to assess outcomes. Therefore this review fills a gap in existing literature
Purpose-The purpose of this paper is to investigate the effectiveness of a day treatment programme (DTP) in reducing psychosocial impairment, changing attitudes, restoring bodyweight and decreasing binge/vomit symptoms among 52 individuals (aged 16+) with eating disorders. It was hypothesized that day treatment would result in improvements across all variables measured. Design/methodology/approach-In a within-participants design, demographic, physiological and psychological measures were taken on admission to and at discharge from a DTP in the UK. Quantitative outcomes were analysed. Findings-In total, 40 participants were considered to have received an adequate dose of the DTP, having completed at least four weeks on the programme. Analyses supported all hypotheses, with all improvements being statistically significant. Large effect sizes were evident for all outcomes across the whole sample other than shape concern attitudes and weight concern attitudes, which reduced with moderate and moderate-tolarge effect sizes, respectively. Originality/value-This study provides new evidence of the effectiveness of day treatment in reducing psychosocial impairment resulting from eating disorder psychopathology. It remains for future research to determine whether these outcomes can be sustained over the longer term.
Purpose This study aimed to investigate the effectiveness of a specialist UK day treatment programme (DTP), in terms of whether improvements in eating disorder symptomology and psychosocial impairment achieved at discharge were maintained at 6-month and 12-month follow-ups. Design/methodology/approach A total of 69 patients (aged 16+) with eating disorders who had received treatment in the DTP were reviewed at 6-month and 12-month follow-ups, using demographic, physiological and psychological measures. Quantitative outcomes were analysed using one-way repeated measures analysis of variance. Findings Data analysis revealed that significant improvements in eating disordered attitudes, body mass index (among underweight participants), binge frequency (among participants with those symptoms) and psychosocial impairment achieved at discharge, were also maintained at 6-month and 12-month follow-ups, and with large effect sizes. All hypotheses were supported, with the exception that frequency of vomiting symptoms had deteriorated at the 12-month follow-up and was no longer significantly different from vomiting frequency on admission. Originality/value Results provide support for the sustained effectiveness of DTPs in improving eating disorder symptoms and psychosocial impairment associated with eating disorders. This is the first study to evaluate the effectiveness of a UK DTP for adults at maintaining improvements to eating disorder symptoms and attitudes at follow-up.
Promoting research in NHS trusts is known to be beneficial for patient outcomes and clinicians’ attitudes towards research and recruitment to studies. Here the authors report their evaluation of a research champions initiative at a specialist mental health and community services trust.
Purpose To evaluate the effectiveness of an adaptation of Interpersonal Group Psychotherapy (IPT-G), in facilitating short- and longer-term improvements in eating disorder symptomology, psychosocial impairment, anxiety, depression and attachment difficulties among adults living with overweight and diagnosed with binge eating disorder (BED). Design/methodology/approach In total, 24 participants completed measures at the start of IPT-G, mid-treatment, discharge and six-month follow-up. Quantitative outcomes were analysed utilising one-way repeated measures analysis of variance. Findings Treatment retention was 100%. Significant improvements in binge-eating frequency, psychosocial impairment and depression were achieved at mid-treatment and maintained at post-treatment and six-month follow-up, and with large effect sizes. Attachment anxiety had reduced significantly at post-treatment and was maintained at six-month review. Body mass index (BMI) had stabilised by mid-treatment and was maintained at post-treatment and six-month follow-up. All hypotheses were supported, with the exception that attachment avoidance did not improve significantly and following a post-treatment reduction, anxiety symptoms deteriorated slightly by six-month follow-up, such that they were no longer significantly different from pre-treatment levels. Practical implications Despite being the most prevalent of the eating disorders (compared to anorexia nervosa and bulimia nervosa), BED is under-recognised and under-treated in clinical settings. Results indicate the sustained effectiveness of IPT-G in improving eating disorder and comorbid symptomology associated with BED. Originality/value This is the first UK study to investigate the effectiveness of IPT-G at treating BED. Unlike previous studies in the field, this study did not exclude participants based on age, BMI or psychiatric comorbidity.
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