Compulsory treatment in anorexia nervosa: A review

Elzakkers, Isis F. F. M.; Danner, Unna N.; Hoek, Hans W.; Schmidt, Ulrike; Elburg, Annemarie

doi:10.1002/eat.22330

Cited by 53 publications

(40 citation statements)

References 57 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…85 Families are the main protective and enabling setting for children’s health, growth, and wellbeing. Economic development has generally brought changes in family structure, stability, and patterns of transition to the next generation of families.…”

Section: Enabling and Protective Systemsmentioning

confidence: 99%

“…Together with declines in marriage, parental deaths from HIV in some countries, and parental migration for employment in others, there has been a global trend towards more single parent families. 85 Living with only one or neither parent is now common in much of sub-Saharan Africa and Latin America. 90,91 In Asia, the Middle East, sub-Saharan Africa, Central America, and South America, large numbers of adolescents now live with extended family members rather than parents.…”

Section: Enabling and Protective Systemsmentioning

confidence: 99%

See 1 more Smart Citation

Our future: a Lancet commission on adolescent health and wellbeing

et al. 2016

View full text Add to dashboard Cite

Section: Enabling and Protective Systemsmentioning

confidence: 99%

Section: Enabling and Protective Systemsmentioning

confidence: 99%

Our future: a Lancet commission on adolescent health and wellbeing

et al. 2016

View full text Add to dashboard Cite

“…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

View full text Add to dashboard Cite

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.

show abstract

“…However, in order to reach that effect, they have more often resorted to nasogastric feeding, which can damage the psychological engagement with the patients (30,31).…”

Section: Discussionmentioning

confidence: 99%

Abordaje nutricional de pacientes ingresados con anorexia nerviosa

Miguelsanz¹,

Hinojal²,

Uribe

et al. 2016

Nutr Hosp

View full text Add to dashboard Cite

ResumenLa anorexia nerviosa (AN) es el trastorno del comportamiento alimentario más prevalente en niños y adolescentes; su tratamiento es largo y complejo, e involucra a múltiples profesionales. La rehabilitación nutricional y la recuperación de un peso corporal normal es uno de los objetivos centrales en las fases iniciales del tratamiento del paciente ingresado. Sin embargo, las recomendaciones actuales sobre los requerimientos energéticos iniciales para estos pacientes son inconsistentes, con una clara ausencia de estudios controlados, evidencia científi ca disponible y consenso global sobre la forma de realimentación más efectiva y segura en adolescentes ingresados con anorexia nerviosa (AN). Clásicamente se han recomendado una realimentación conservadora para prevenir el síndrome de realimentación. No obstante, han aparecido recientemente varios trabajos recomendado una ingesta calórica inicial más elevada, sin observar más complicaciones ni síndrome de realimentación, y asociadas a estancias medias más cortas. Presentamos aquí nuestra experiencia en el tratamiento de la AN restrictiva con un tratamiento progresivo conservador. Hemos obtenido buenos resultados con este abordaje, bien tolerando por los pacientes, y sin observar complicaciones. Gracias a él, el equipo médico pudo establecer más fácilmente un acuerdo sobre los objetivos terapéuticos con el paciente. AbstractAnorexia nervosa (AN) is the most prevalent of eating disorders in children and adolescents, and its treatment is long and complex, involving a multidisciplinary team. Nutritional rehabilitation and restoration of a healthy body weight is one of the central goals in the initial stages of inpatient treatment. However, current recommendations on initial energy requirements for these patients are inconsistent, with a clear lack of controlled studies, available scientifi c evidence and global consensus on the most effective and safe refeeding practices in hospitalized adolescents with anorexia nervosa (AN). Conservative refeeding recommendations have been classically established in order to prevent the refeeding syndrome. Nevertheless, various works have recently appeared advocating a higher initial caloric intake, without observing more complications or refeeding syndrome, and allowing a shorter average stay. We present our experience in the treatment of restricting AN with a conservative progressive treatment. We have obtained good results with this approach, which was well tolerated by patients, with no observing complications. As a consequence, the medical team could establish a pact about the therapeutic goals with the patients in an easier way.

show abstract

Compulsory treatment in anorexia nervosa: A review

Abstract: In severe cases of AN where the patient refuses life-saving treatment compulsory treatment needs to be considered. Future research should focus on the longer term effects of compulsory treatment and also on questions related to mental capacity in AN.

Cited by 53 publications

References 57 publications

Our future: a Lancet commission on adolescent health and wellbeing

Our future: a Lancet commission on adolescent health and wellbeing

Systematic review of evidence for different treatment settings in anorexia nervosa

Abordaje nutricional de pacientes ingresados con anorexia nerviosa

Contact Info

Product

Resources

About