Long-term Outcome of Residential Treatment for Anorexia Nervosa and Bulimia Nervosa

Abstract

We analyzed results from surveys of respondents who had completed ≥ 30 days of treatment at Monte Nido Residential Treatment Program over a 10 year period. Participants with anorexia nervosa (AN; n = 66) and bulimia nervosa (BN; n = 52) completed the Eating Disorders Inventory-2 (EDI-2), the Beck Depression Inventory (BDI), and a structured eating disorder assessment at admission and follow-up. Mean duration between discharge and last follow-up was 4.6 years and 3.8 years for AN and BN respectively. For AN there were significant improvements in BMI, BDI, 10 of 11 EDI-2 subscales, and frequencies of bingeing and purging. For BN there were significant improvements in BDI, all EDI subscales, and frequencies of bingeing and purging. Eighty-nine percent of AN graduates and 75% of BN graduates had good or intermediate outcomes. Using linear regression, the best model contained the single variable, discharge BMI, which predicted 23% of the variance explaining full recovery from AN (p ≤ .02). For BN, the best model contained vomiting frequency and the bulimia subscale score of the EDI-2 at discharge, which accounted for 37% of the variance explaining full recovery from BN (p ≤ .02). The great majority of patients showed significant improvement at long-term follow-up after this program of residential treatment. In addition, these results underscore the importance of weight gain for AN patients and cessation of bulimic symptoms for BN patients when predicting long-term recovery.

How effective is bibliotherapy-based self-help cognitive behavioral therapy with Internet support in clinical settings? Results from a pilot study

“…In DPP we found that lower frequency of vomiting trend significantly predicted better outcome. A similar result was found in a study on long-term outcome [37]; frequency of vomiting in BN at time of discharge from residential treatment was predictive of outcome at follow-up. Why we found fewer predictors in DPP could be that fewer analyses were performed for this group or that a more intensive treatment is less sensitive to patient characteristics.…”

Prognostic factors and outcome in anorexia nervosa: a follow-up study

“…Half of deaths were due to suicide, while other causes included alcohol abuse or medical consequences of marasmic malnutrition [5]. Short-term evaluations showed good outcomes ranging from 18 [6] to 42 % [7]. The 4-year or 5-year clinical recovery rate was higher and it was influenced by the duration of follow-up [8][9][10][11].…”

A clinical approach to the assessment and management of co-morbid eating disorders and substance use disorders

“…Residential treatment programmes have been found to be effective in the treatment of AN and BN both post-treatment and at 3–4 year follow-up [101,102]. Treatment for EDs may also take place within substance abuse treatment programmes, however not all such programmes are equipped with adequate knowledge or resources [93].…”