Treatment of chronic anorexia nervosa: a 4‐year follow‐up of adult patients treated in an acute inpatient setting

Abstract

Despite evidence from a number of long-term follow-up studies of anorexia nervosa that nearly 50% of patients eventually make a full recovery, controlled trials of psychotherapy for anorexia nervosa are lacking. Those with severe and enduring problems represent a considerable therapeutic challenge. Thirty-four consecutive adult referrals to the inpatient treatment unit who fulfilled Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition diagnostic criteria for anorexia nervosa were examined pre-admission, post-discharge and 4 years after admission. Characteristics of remitted and non-remitted patients were examined. Secondary analyses considered the differences between patients with anorexia nervosa, restricting type and anorexia nervosa binging/purging type. The findings highlight a number of differences between patients with anorexia nervosa (restricting type) versus anorexia nervosa (binging/purging type) as well as remitted versus non-remitted patients. The use of a comprehensive battery of assessments found that resolution of eating disorder symptomatology was paralleled by improvements in emotional and psychological distress and improvement in body image perception and coping skills. Better results were obtained for those who had continuity of care on an outpatient basis. This pattern is particularly significant given the more 'chronic' nature of the sample that were older, with a higher incidence of binge-eating and purging than previous samples. Results provide some encouragement for the treatment of those adults with anorexia nervosa who typically have less favourable outcomes.

Patients’ perspective on inpatient treatment for eating disorders: A mixed-methods study of satisfaction, experience of care and perceived helpfulness of components of treatment

“…Research demonstrates that outcomes of, and satisfaction with inpatient treatment for AN are variable [25] with minority of patients finding treatment 'extremely helpful' [7]. While weight may be restored, psychological symptoms remain and repeated readmission is common [7,[26][27][28].…”

Comparing carer wellbeing: implications for eating disorders

“…The term "severe and enduring eating disorders" (SEED) (Robinson, 2009) is a contemporary term used in clinical settings to identify people with an ED who experience the condition in a severe and enduring form. To date there is little consensus on the definition of SEED (Arkell and Robinson, 2008;Bamford et al, 2014;Elbaky et al, 2014;Long et al, 2012;Wonderlich et al, 2012). For example, six, seven and ten years duration of the illness have been used, in addition to the number of failed treatment attempts or body mass index.…”

Hospitalização integral para tratamento dos transtornos alimentares: a experiência de um serviço especializado

“…A AN, por causa de suas graves consequências nos sistemas orgânicos decorrentes da desnutrição, é o diagnóstico de TA mais prevalente nas intervenções hospitalares [22][23][24] . A distribuição dos pacientes internados pelo GRATA de acordo com o diagnóstico também demonstrou preponderância de AN, sobretudo em seu subtipo restritivo.…”