Naturalistic outcomes for a day‐hospital programme in a mixed diagnostic sample of adolescents with eating disorders

Abstract

Despite initial data suggesting positive treatment outcomes for adolescent eating disorder day-hospital programmes (DHPs), existing studies have included limited follow-up, small samples, and a focus on restricting-type eating disorders. To address these gaps, we explored naturalistic outcomes for an adolescent eating disorders DHP. Adolescent participants (N = 265) completed measurements at treatment admission, discharge (n = 170), and various lengths of follow-up (n = 126; M follow up = 278.87 days). Results from multilevel models indicated significant increases in body weight for the anorexia nervosa group throughout treatment and maintenance of increased body weight from discharge to follow-up. In bulimic spectrum disorders, binge eating and purging significantly decreased from intake to discharge and did not change from discharge to follow-up. Across the entire sample, eating disorder symptoms decreased from intake to discharge and did not change from discharge to follow-up. Further, anxiety and depression decreased over the course of treatment and continued to decrease over the follow-up period. The current investigation represents the first study to explore longitudinal DHP outcomes within adolescent bulimic spectrum eating disorders. Our findings also highlight many challenges inherent in conducting naturalistic research; it is critical that the field continue to develop solutions to the barriers inherent in conducting longitudinal research on eating disorder treatment. K E Y W O R D Sadolescent, day-hospital care, eating disorders, treatment

Examining day hospital treatment outcomes for sexual minority patients with eating disorders

“…In regard to demographics, there were no significant racial/ethnic differences between groups, however, the sample was largely comprised of young, White patients, thus, results may not be generalizable to other cultural or generational groups. Notably, there was a substantial amount of missing data at follow‐up, which is a common issue across multiple adult PHP program outcome studies of similar design (Brown et al, 2018; Reilly et al, 2020). While our data did not suggest biased attrition, we did not collect information as to why some patients did not complete the one‐month or discharge assessments.…”

“…Programming was designed based on the dialectical behavior therapy (DBT) model and guidelines for severe and complex EDs (Wisniewski, Safer, & Chen, 2007) and offered all elements of standard DBT, including DBT skills groups, individual therapy, phone coaching, and DBT consultation teams (see Brown et al, 2018 for more details). Adolescent programming used a blended family‐based therapy (FBT)‐DBT approach (see Reilly et al, 2020 for more details). In addition to DBT/FBT‐based programming, patients ate three meals and two snacks per day in program and participated in two to three other ED‐related groups per day.…”

Optimising care pathways for adult anorexia nervosa. What is the evidence to guide the provision of high‐quality, cost‐effective services?

“…A variety of alternative forms of specialised intensive care have been introduced (home treatments, day and residential care, specialised group therapies for ED subtypes/gender, etc. ; Agüera et al, 2017;Anastasiadou et al, 2020;Peckmezian & Paxton, 2020;Reilly, Rockwell, & Ramirez, 2020;Serrano-Troncoso et al, 2020).…”

Adolescent Eating Disorder Day Programme Treatment Models and Outcomes: A Systematic Scoping Review

“…It is also widely reported that following DP treatment young people report reductions in a range of core eating disorder symptoms and cognitions, such as drive for thinness, shape and weight concerns and body dissatisfaction (see Table 2 ). Similarly, for those with binge/purge behaviors at assessment, reductions are reported by end of treatment ( 34 – 36 , 58 ).…”

“…Some programmes also offer an additional tier of intervention between DP and outpatient care. In the USA particularly it has been common to offer both a partial hospitalization program (more intensive) and an intensive outpatient program (less intensive), within the same treatment center [e.g., ( 34 , 37 , 39 , 40 , 53 )], which may be partially influenced by insurance requirements.…”