Body Weight as a Prognostic Factor for Day Hospital Success in Adolescents With Anorexia Nervosa

Ngo, Michelle; Isserlin, Leanna

doi:10.1080/10640266.2014.857522

Cited by 15 publications

(27 citation statements)

References 16 publications

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“…It is not always clear in the literature which programs require full time attendance and which taper down attendance to allow engagement with real life. However, our review of the literature suggests that mean attendance of 30 days is lower than some programs (e.g.,Grewal et al, —200.4 days; Ngo & Isserlin, —81.9 days) though comparable with others (Ornstein et al, —33.3 days) including the average length of stay for AN group (11.94 weeks) in the Ornstein et al () study. Discharge from ITP is clinically determined, but clinical need is determined in the context of it being a component of a comprehensive outpatient treatment program.…”

Section: Discussionsupporting

confidence: 77%

“…In contrast with other programs who have fixed discharge target weights (92.5%–100% IBW, Ngo & Isserlin, ; between 15th and 20th age adjusted centile, approximately corresponding to 88–90%mBMI, Herpertz‐Dahlmann et al, ; 100% of target weight, Grewal et al, ), the mean %mBMI (86.83%, range 65–116) for young people who completed ITP is more similar to the discharge weight in the Goldstein et al () 10 weeks fixed length day program (84.14%, SD 10.01). However it is worth noting that programs who had fixed weight targets as a criteria for the successful program completion also report high rates of young people disengaging from the program for example 38% (Dancyger et al, ) and 42% (Grewal et al, ).…”

Section: Discussionmentioning

confidence: 82%

“…In contrast with other programs who have fixed discharge target weights (92.5%-100% IBW, Ngo & Isserlin, 2014 (Dancyger et al, 2003) and 42% (Grewal et al, 2013).…”

Section: Discussionmentioning

confidence: 97%

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Intensive treatment program (ITP): A case series service evaluation of the effectiveness of day patient treatment for adolescents with a restrictive eating disorder

Simic

Stewart

Eisler

et al. 2018

Intl J Eating Disorders

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Objective Family Therapy for Anorexia Nervosa (FT‐AN) is the first line treatment for adolescents with anorexia nervosa in the UK. However, research suggests between 10 and 40% of young people have a poor outcome. For those for whom FT‐AN alone is not effective there is a clear need to develop additional treatments. This paper describes the effectiveness of an additional treatment for adolescents who had not responded to FT‐AN, the Intensive Day Treatment Program (ITP) embedded within a comprehensive outpatient service at the Maudsley Hospital. Method Data from a retrospective chart review of patient files were analyzed for 105 young people aged 11–18 with restrictive eating disorders referred to the program in the first four and a half years of its operation. Results Young people attended ITP for only on average 28.41 days. Over this time they made significant improvements in a range of domains, including weight gain, eating disorder symptomatology, motivation to recover, quality of life and comorbid symptomatology. Young people continued to make improvements post ITP in outpatient treatment provided by the same service and 73.2% had a good or an intermediate outcome at the point of discharge from the service. Discussion This uncontrolled case series indicates that ITP can contribute to positive outcomes for young people who require intensification of treatment. ITP outcomes are discussed in comparison to the published literature concerning day programs for adolescents with a diagnosis of an eating disorder.

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Section: Discussionsupporting

confidence: 77%

Section: Discussionmentioning

confidence: 82%

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Intensive treatment program (ITP): A case series service evaluation of the effectiveness of day patient treatment for adolescents with a restrictive eating disorder

Simic

Stewart

Eisler

et al. 2018

Intl J Eating Disorders

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“…The Pubmed search resulted in 192 titles for inspection and 7 abstracts for inspection of which 5 were not trials of treatment setting [28][29][30][31][32] and one was a review [33] and one new trial [34] was identified. The CCRCT Issue 6 of 12, June 2014 (n = 797723) search resulted in 20 titles for inspection of which two were duplicates and one new trial [29] was identified ( Figure 1).…”

Section: Results Of Searchmentioning

confidence: 99%

Systematic review of evidence for different treatment settings in anorexia nervosa

Madden

Hay

Touyz

2015

WJP

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AIM:To compare outcomes in anorexia nervosa (AN) in different treatment settings: inpatient, partial hospitalization and outpatient. METHODS:Completed and published in the English language, randomized controlled trials comparing treatment in two or more settings or comparing different lengths of inpatient stay, were identified by database searches using terms "anorexia nervosa" and "treatment" dated to July 2014. Trials were assessed for risk of bias and quality according to the Cochrane handbook by two authors (Madden S and Hay P) Data were extracted on trial quality, participant features and setting, main outcomes and attrition. RESULTS:Five studies were identified, two comparing inpatient treatment to outpatient treatment, one study comparing different lengths of inpatient treatment, one comparing inpatient treatment to day patient treatment and one comparing day patient treatment with outpatient treatment. There was no difference in treatment outcomes between the different treatment settings and different lengths of inpatient treatment. Both outpatient treatment and day patient treatment were significantly cheaper than inpatient treatment. Brief inpatient treatment followed by evidence based outpatient care was also cheaper than prolonged inpatient care for weight normalization also followed by evidence based outpatient care. CONCLUSION:There is preliminary support for AN treatment in less restrictive settings but more research is needed to identify the optimum treatment setting for anorexia nervosa. Core tip: Anorexia nervosa (AN) is a serious disorder incurring high costs due to hospitalization. This study compared outcomes in AN treatment studies comparing different treatment settings: inpatient, day-patient and outpatient. Five studies were identified. There was no difference in outcomes between the different settings and lengths of inpatient treatment. Both outpatient and day-patient treatment were significantly cheaper than inpatient treatment. Brief inpatient treatment followed by evidence based outpatient care was cheaper than prolonged inpatient care for weight normalization. There is support for AN treatment in less restrictive settings but more research is needed to identify the optimum treatment setting.

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“…Furthermore, younger age and comorbid PD seemed to be significant predictors for treatment dropout. One of the most striking results was that younger patients (17)(18)(19)(20)(21)(22)(23)(24) without a comorbid PD had the highest weight gain during treatment. This could not be observed in patients with a comorbid PD, who demonstrated the highest weight gain between 25 and 34 years of age.…”

Section: Introductionmentioning

confidence: 99%

Stationärer Therapieerfolg bei Patientinnen mit Anorexia Nervosa und komorbiden Persönlichkeitsstörungen

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Beermann

Mestel

et al. 2017

Psychother Psych Med

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Personality disorders (PD) are among the most common comorbid disorders in female patients with Anorexia Nervosa (AN). Recent research findings suggest that comorbid PD are associated with a higher treatment drop-out rate and a worse therapeutic outcome. However, no study to date has distinguished between certain age groups concerning these issues. Therefore, the present study focuses on the prevalence of PD (1), treatment drop-out rates (2) and weight gain (3) in female in-patients with AN. Thereby, we differentiate among three age groups (17-24 years; 25-34 years; 35-65 years). We assessed female in-patients (N=331) with AN at the Helios Clinic in Bad Grönenbach in Germany using the Eating Disorders Inventory-2 and the psychotherapeutic-medical basic documentation at the beginning and at the end of their treatment. Furthermore, we investigated the drop-out rate and weight gain by comparing anorexic patients with and without comorbid PD that were diagnosed by clinicians using ICD-10 criteria. In sum, our patients with AN demonstrated a prevalence rate of 34% for one or more comorbid PD. Interestingly, patients between 17-24 years showed a lower prevalence rate of 22% compared to those between 25-34 years (42%) and 35-65 years (41%). Furthermore, younger age and comorbid PD seemed to be significant predictors for treatment dropout. One of the most striking results was that younger patients (17-24) without a comorbid PD had the highest weight gain during treatment. This could not be observed in patients with a comorbid PD, who demonstrated the highest weight gain between 25 and 34 years of age. Our findings support the hypothesis that comorbid PD are related to a worse outcome in patients with eating disorders. Future studies might do well in assessing dimensional scores of personality disorders and other relevant aspects like for example the amount of social support to draw further conclusions on these associations. Our results emphasize the need for more disorder-specific interventions tailoring at patients with AN and comorbid PD to improve treatment outcome.

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Body Weight as a Prognostic Factor for Day Hospital Success in Adolescents With Anorexia Nervosa

Cited by 15 publications

References 16 publications

Intensive treatment program (ITP): A case series service evaluation of the effectiveness of day patient treatment for adolescents with a restrictive eating disorder

Intensive treatment program (ITP): A case series service evaluation of the effectiveness of day patient treatment for adolescents with a restrictive eating disorder

Systematic review of evidence for different treatment settings in anorexia nervosa

Stationärer Therapieerfolg bei Patientinnen mit Anorexia Nervosa und komorbiden Persönlichkeitsstörungen

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