Naturalistic Outcome of Family‐Based Inpatient Treatment for Adolescents with Anorexia Nervosa

Halvorsen, Inger; Reas, Deborah L.; Nilsen, Jan-Vegard; Rø, Øyvind

doi:10.1002/erv.2572

Cited by 29 publications

(41 citation statements)

References 22 publications

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“…Anorexia nervosa There were three studies found examining inpatient treatment utilizing a family-based approach, one of which included 37 patients [211], and the other two studies which included one patient each (i.e. case reports) [39,63] (Table 41).…”

Section: Family-based Inpatient Carementioning

confidence: 99%

“…case reports) [39,63] (Table 41). Length of stay in hospital was a mean of 20.6 weeks (SD = 13.6, range 3-58) in the first study [211] and 10 days in one case report [39] and unclear in the second case report [63]. Mean weight gain was reported as 7.5 kg in the case series [211], a change in BMI from 16.32 to 17.5 in one case report [39], and a change in BMI of 15.4 to 19.5 in the other case report [63].…”

Section: Family-based Inpatient Carementioning

confidence: 99%

“…Length of stay in hospital was a mean of 20.6 weeks (SD = 13.6, range 3-58) in the first study [211] and 10 days in one case report [39] and unclear in the second case report [63]. Mean weight gain was reported as 7.5 kg in the case series [211], a change in BMI from 16.32 to 17.5 in one case report [39], and a change in BMI of 15.4 to 19.5 in the other case report [63]. In the case report by Goldfield and Boachie [63], the family received eight sessions of family-based informed therapy via telepsychiatry as one parent and siblings were not local.…”

Section: Family-based Inpatient Carementioning

confidence: 99%

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Canadian practice guidelines for the treatment of children and adolescents with eating disorders

et al. 2020

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Objectives: Eating disorders are common and serious conditions affecting up to 4% of the population. The mortality rate is high. Despite the seriousness and prevalence of eating disorders in children and adolescents, no Canadian practice guidelines exist to facilitate treatment decisions. This leaves clinicians without any guidance as to which treatment they should use. Our objective was to produce such a guideline. Methods: Using systematic review, the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system, and the assembly of a panel of diverse stakeholders from across the country, we developed high quality treatment guidelines that are focused on interventions for children and adolescents with eating disorders. Results: Strong recommendations were supported specifically in favour of Family-Based Treatment, and more generally in terms of least intensive treatment environment. Weak recommendations in favour of Multi-Family Therapy, Cognitive Behavioural Therapy, Adolescent Focused Psychotherapy, adjunctive Yoga and atypical antipsychotics were confirmed. Conclusions: Several gaps for future work were identified including enhanced research efforts on new primary and adjunctive treatments in order to address severe eating disorders and complex co-morbidities.

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Section: Family-based Inpatient Carementioning

confidence: 99%

Section: Family-based Inpatient Carementioning

confidence: 99%

Section: Family-based Inpatient Carementioning

confidence: 99%

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Canadian practice guidelines for the treatment of children and adolescents with eating disorders

et al. 2020

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“…The child and adolescent inpatient unit admits patients up to 18 years old, and has beds for a maximum of five patients and their families. Details regarding the adaptation of FBT to an inpatient treatment setting have been described elsewhere [17,18].…”

Section: Setting and Participantsmentioning

confidence: 99%

Physical restraint during inpatient treatment of adolescent anorexia nervosa: frequency, clinical correlates, and associations with outcome at five-year follow-up

2020

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Background: Studies of the use and effects of physical restraint in anorexia nervosa (AN) treatment are lacking. The purpose of this study was to describe the frequency of physical restraint in a specialized program for adolescents with AN, and to examine if meal-related physical restraint (forced nasogastric tube-feeding) was related to 5-year outcome. Method: Thirty-eight (66% of 58) patients with AN (mean age 15.9, SD = 1.9) admitted to a regional, specialized adolescent eating disorders (ED) inpatient unit. Patient data, including restraint episodes, were obtained from hospital records, and outcome was assessed at a 5-year follow-up. Results: A total of 201 restraint episodes occurred over 5513 days of inpatient treatment, including 109 meal-related episodes and 56 episodes to avoid self-harm. Twelve (32%) patients experienced at least one restraint episode during the admission, of which eight (21%) experienced meal-related restraint. Four patients represented 91% of all restraint episodes, experiencing 10 or more episodes during admission. Meal-related restraint was significantly associated with a higher rate of persisting ED diagnosis, but not with weight gain during admission, EDE-Q global score or BMI at follow-up. Conclusions: Restraint episodes occurred rather infrequently. A small number of patients (n = 4) accounted for a high proportion of episodes (91%). More knowledge is important to reduce the need for restraint in treatment for AN.

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“…Three studies (total n = 39) examined inpatient treatment utilizing a family-based approach [38][39][40], and three papers (total n = 296) reported on inpatient treatment utilizing a cognitive behavioural (CBT) approach [41][42][43]. In all studies patients gained weight in hospital, although measures by which weight changes were reported varied, as did LOS (Table 1).…”

Section: Resultsmentioning

confidence: 99%

Outcomes of inpatient psychological treatments for children and adolescents with eating disorders at time of discharge: a systematic review

et al. 2020

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Background: Recommended first line treatment for children and adolescent eating disorders is outpatient therapy. However, a significant number of children and adolescents with eating disorders continue to require inpatient treatment during the course of their illness. The effect of psychological treatments in an inpatient setting on outcomes at the time of discharge remains unclear. This paper presents the results of a review of the literature on outcomes at the time of discharge following inpatient psychological treatment for children and adolescents with eating disorders. Main body: The majority of studies found were observational and of low quality. The most consistently reported positive outcome of inpatient treatment is weight gain. Results related to symptom change and motivation vary between studies. Within the inpatient setting, there is considerable heterogeneity in the types of treatments offered, goals of treatment, length of stay and outcomes measured. Conclusion: There remains a paucity of high-quality studies examining the effect of psychological treatments provided to children and adolescents in an inpatient setting. The significant heterogeneity between studies makes it not possible to compare across studies. Future research should aim to resolve these deficiencies in order to better determine the specific factors that contribute to positive outcomes of inpatient treatment for children and adolescents with eating disorders.

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Naturalistic Outcome of Family‐Based Inpatient Treatment for Adolescents with Anorexia Nervosa

Abstract: Inpatient family-based therapy for AN may be a promising therapeutic approach for adolescents that fail to respond to outpatient treatment and should be investigated further. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.

Cited by 29 publications

References 22 publications

Canadian practice guidelines for the treatment of children and adolescents with eating disorders

Canadian practice guidelines for the treatment of children and adolescents with eating disorders

Physical restraint during inpatient treatment of adolescent anorexia nervosa: frequency, clinical correlates, and associations with outcome at five-year follow-up

Outcomes of inpatient psychological treatments for children and adolescents with eating disorders at time of discharge: a systematic review

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