Predictors of rehospitalization after total weight recovery in adolescents with anorexia nervosa

Castro, Josefina; Gila, Araceli; Puig, Josefina; Rodríguez, Sónia; Toro, Josep

doi:10.1002/eat.20009

Cited by 88 publications

(90 citation statements)

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“…37 Evidence currently confirms that a slow rate of weight gain in treatment as well as a low BMI at discharge predicts poor long term outcomes and readmissions. 40,46,76,77 Given that, as this study suggests, persons with AN differ in their short-term outcomes based on RFC, a variable known at the time of admission and modifiable through RFC-specific treatment interventions, further research should assess whether stage of change focused treatment can affect RFC, the associated outcomes, and LOS.…”

Section: Resultsmentioning

confidence: 99%

“…On the other hand, weight gain in treatment at a rate that is too slow has been correlated with readmission to hospital. 46 Length of stay has been correlated with insurance status suggesting that a person's ability to pay for treatment influences how long they will be treated at a higher level of care. 47 This raises issues concerning fairness and the constraints on healthcare providers' abilities to carry out evidence-based clinical decisions regarding the appropriate setting and duration of care.…”

Section: Length Of Staymentioning

confidence: 99%

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Readiness for change and short‐term outcomes of female adolescents in residential treatment for anorexia nervosa

McHugh

2007

Intl J Eating Disorders

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Objective: To determine if readiness for change (RFC) at admission predicted length of stay (LOS) and short-term outcomes among female adolescents in residential treatment for anorexia nervosa (AN).Method: Using a prospective cohort design to collect data from participants (N 5 65) at admission and discharge, KaplanMeier survival analysis and Cox regression tested whether RFC on admission predicted time in LOS to a favorable short-term outcome-a composite endpoint based on minimum criteria for weight gain, drive for thinness, depression, anxiety, and healthrelated quality of life (HRQOL).Results: Participants with low RFC had a mean survival time to a favorable short-term outcome of 59.4 days compared to 34.1 days for those with high RFC (log rank 5 8.44, df 5 1, p 5 .003). The probability of a favorable short-term outcome was 5.30 times greater for participants with high RFC. Conclusion:Readiness for change is a useful predictor of a favorable short-term outcome and should be considered in the assessment profile of patients with AN. V V C 2007 by Wiley Periodicals, Inc.

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Section: Resultsmentioning

confidence: 99%

Section: Length Of Staymentioning

confidence: 99%

Readiness for change and short‐term outcomes of female adolescents in residential treatment for anorexia nervosa

McHugh

2007

Intl J Eating Disorders

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“…He also found that longer duration of the follow up and younger age at onset of the illness were associated with better outcome. However, a different study 8 found that lower age at onset was predictive of readmission of patients within 12 months of completing their initial treatment. Contrary to these findings, another study 9 found that age at onset was not a significant predictor of outcome.…”

mentioning

confidence: 94%

“…Previous research into recovering from AN has predominantly focused on defining the recovery from AN the patient perspective [1][2][3][4][5][6] and looked at predictors of recovery using quantitative criteria such as length of treatment and follow up or age at onset [7][8][9] with mixed results.…”

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confidence: 99%

Becoming ‘whole’ again: A qualitative study of women's views of recovering from anorexia nervosa

Jenkins

Ogden

2011

Euro Eating Disorders Rev

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Objectives: The study explored women's perceptions of their recovery process and what recovery means to them in order to gain a better understanding of the predictors of recovery from anorexia nervosa (AN).Method: The data were analysed usingInterpretative Phenomenological Analysis (IPA). Semi-structured telephone interviews were carried out with fifteen women who received a diagnosis of AN and defined themselves as recovered/in recovery. The women were recruited from beat. Results:The women described their experiences in terms of four broad areas; being anorexic; dissatisfaction with treatment; process of change; and being recovered. Whilst anorexic, women experienced a series of dichotomies. In particular, they described splits between mind and body, AN behaviour and cognitions and rational and irrational side. Recovery occurred when the above dichotomies became resolved. Conclusion:Recovery occurs only when an individual becomes "whole" again, which is a lengthy psychological process. Therefore, it is also essential that therapy is not discontinued after patients reach their target weight.

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“…la mayor o menor ganancia ponderal es bastante impredecible 4 , existiendo, además, una falta de consenso al fijar el objetivo de recuperación en adolescentes en desarrollo, habiéndose propuesto el uso de percentiles de IMC y fijado un rango entre 14 y 39 como objetivo inicial 28 . La inadecuada recuperación ponderal, actitudes alimentarias anómalas y baja edad, se han relacionado con rehospitalizaciones 29 , siendo la adecuada ganancia ponderal el mejor predictor, a corto plazo, de menor deterioro clínico 30 . Un mejor peso inicial también se ha relacionado positivamente con un mejor mantenimiento posterior del mismo 31 y, a largo plazo, la normalización ponderal y del estado nutricional parecen también determinantes de un buen pronóstico 32 .…”

Section: Objetivos Terapéuticosunclassified

Revisión del tratamiento dietético-nutricional de la anorexia nerviosa

Jáuregui‐Lobera

Bolaños-Ríos

2012

Rev. méd. Chile

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Review of nutritional and dietary management of anorexia nervosaFax: +34954278167 E-mail: ijl@tcasevilla.com L a anorexia nerviosa es un trastorno habitualmente de curso prolongado, con manifestaciones psicofísicas diversas 1 . Un porcentaje de pacientes puede morir, por suicidio o complicaciones físicas, siendo frecuente la muerte súbita por cardioarritmias 1-3 , que no guarda relación con la duración de la enfermedad o la edad, pero sí con un índice de masa corporal (IMC) < 12 y niveles muy bajos de albúmina sérica 4 , aunque el riesgo de dicho desenlace es poco predecible, dada la variable respuesta individual a la desnutrición y la influencia de otros factores 5,6 . En las complicaciones influyen el bajo peso, atracones, conductas purgativas, ejercicio extenuante y autolesiones 4 , siendo reversibles con una adecuada recuperación ponderal 7 . La prevalencia del trastorno es 0,2-0,5% 8 , afectando más a las mujeres 9 , pero con iguales efectos en los varones 10 . Aún sin demostrar que la ratio mujeres-hombres esté cambiando, lo que sí ha aumentado es el rango de edad de aparición, considerando que el rango tradicional de afectación era de 15 a 24 años para la mayoría de los casos 1 .La morbi-mortalidad asociada y la compleja naturaleza del trastorno, implican un tratamiento interdisciplinar 11 , muchas veces intensivo 12 , siendo los dietistas-nutricionistas los mejor cualificados para manejar aspectos dietético-nutricionales 13 , como el restablecimiento ponderal, el logro de una ingesta que cubra los requerimientos y una adecuada educación nutricional 4 .El objetivo del trabajo fue revisar los aspectos dietético-nutricionales del tratamiento de la anorexia nerviosa, enfatizando las tareas y estándares necesarios a proporcionar por parte de los dietistas-nutricionistas en el contexto de un equipo interdisciplinar y en diferentes ámbitos: ambulatorio, hospitalario y de hospitalización parcial (unidades de día). Material y MétodosSe hizo una revisión selectiva de las publicaciones indizadas en PubMed, sin carácter de revisión sistemática ni metaanálisis. Se incluyeron trabajos relacionados con el tratamiento dietético-

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Predictors of rehospitalization after total weight recovery in adolescents with anorexia nervosa

Abstract: The variables most clearly related to readmission were young age, abnormal eating attitudes, and a low rate of weight gain.

Cited by 88 publications

References 20 publications

Readiness for change and short‐term outcomes of female adolescents in residential treatment for anorexia nervosa

Readiness for change and short‐term outcomes of female adolescents in residential treatment for anorexia nervosa

Becoming ‘whole’ again: A qualitative study of women's views of recovering from anorexia nervosa

Revisión del tratamiento dietético-nutricional de la anorexia nerviosa

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