Predictors of short-term outcome variables in hospitalised female adolescents with eating disorders

Mekori, Ehud; Halevy, Liron; Ziv, Shimrit Ilana; Moreno, A. Gatón; Enoch‐Levy, Adi; Weizman, Abraham; Stein, Dan J.

doi:10.1080/13651501.2016.1229794

Cited by 20 publications

(32 citation statements)

References 49 publications

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“…Only BMI at admission was associated with this clinical outcome. This is in line with findings from other authors (Agüera et al, 2015;Mekori et al, 2017) who reported that admission BMI was predictive of BMI at follow-up among patients with AN.…”

Section: Discussionsupporting

confidence: 93%

Retrospective analysis of hypophosphatemia rates and other clinical parameters in patients with eating disorders

Richardson

Huniewicz

Paslakis

2020

Euro Eating Disorders Rev

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To retrospectively assess medical services of a specialist inpatient eating disorders (EDs) unit. Method: We retrospectively evaluated clinical parameters of 288 inpatients classified as 'moderately' or 'significantly' medically compromised between 1 January 2016 and 30 June 2019. Results: We analysed 288 patients (mean age 32.5 [SD ¼ 11.4] years, 96% women, 76% with anorexia nervosa). Average length of stay was 38.4 (SD ¼ 28.4) days. Average admission body mass index (BMI) was 14.8 (SD ¼ 1.8) kg/m 2 , and 16.1 (SD ¼ 1.9) kg/m 2 at 4 weeks. At admission, 82% of patients were considered significantly medically compromised, while 6% were deemed moderately compromised. Only 5% of patients required transfer to intensive care unit. Prevalence of hypophosphatemia was 17.7%; rates did not increase significantly between years despite more assertive re-feeding processes. There was no association between risk classification at admission and change in BMI at 4 weeks (F (2,166) ¼ 0.588, p ¼ 0.557). BMI at admission was found to be significantly associated with clinical outcome (β ¼ 0.92, p < 0.001). Discussion: Hypophosphatemia rates did not increase despite more assertive re-feeding over 3 years. Our results provide support for a model of treatment that simultaneously addresses the medical and psychiatric sequelae of patients with severe EDs. K E Y W O R D S anorexia nervosa, bulimia nervosa, comorbidity, re-feeding, psychotherapy 1 | INTRODUCTION Anorexia nervosa (AN) is a chronic disorder associated with high relapse rates, treatment costs and diminished quality of life (Hay et al., 2017; Khalsa, Portnoff, McCurdy-McKinnon, & Feusner, 2017; Schalla & Stengel, 2019). AN has a 12-fold higher mortality rate than all other causes of death among females between 15 and 24

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Section: Discussionsupporting

confidence: 93%

Retrospective analysis of hypophosphatemia rates and other clinical parameters in patients with eating disorders

Richardson

Huniewicz

Paslakis

2020

Euro Eating Disorders Rev

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“…Mixed diagnoses Two studies of multimodal inpatient treatment were found which reported on weight gain during inpatient treatment for patients with mixed eating disorder diagnoses (Table 39). One study differentiated between patients with AN restricting type versus those with AN binge-purge type or BN [203], and the other differentiated between those with AN restricting type or AN binge-purge type versus those with BN or Eating Disorder Not Otherwise Specified binge-purge type (EDNOS-B/P) [193]. Multimodal treatment was provided in both studies but varied between studies.…”

Section: Multimodal Treatmentmentioning

confidence: 99%

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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“…We failed to identify any RCTs exploring outcomes of inpatient treatment specifically for pediatric AN, including atypical anorexia nervosa. We identified twenty studies (total n = 1091) describing inpatient treatment based on an integrative approach for AN, including psychiatric, medical, nutritional, and pharmacologic management, as well as individual, group and family therapy along with skilled nursing support [18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37]. None of these studies included control or comparison groups.…”

Section: Resultsmentioning

confidence: 99%

“…Three studies using an integrative approach (total n = 239) were included and reported on weight gain during inpatient treatment for patients with mixed ED diagnoses [9,28,30] (Table 2). The studies included in this [28,30].…”

Section: Inpatient Programs For Mixed Ed Diagnoses Weight Gainmentioning

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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Predictors of short-term outcome variables in hospitalised female adolescents with eating disorders

Abstract: In EDs, diverse factors may predict different outcome variables.

Cited by 20 publications

References 49 publications

Retrospective analysis of hypophosphatemia rates and other clinical parameters in patients with eating disorders

Retrospective analysis of hypophosphatemia rates and other clinical parameters in patients with eating disorders

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

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

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