This study evaluated the clinical significance as well as predictors of outcome for adolescents with severe anorexia nervosa (AN) treated in an inpatient setting. Body mass index (BMI), eating disorder (ED) symptoms [Eating Disorder Inventory-2 (EDI-2)], general psychopathology and depression were assessed in 238 patients at admission and discharge. BMI increased from 14.8 + 1.2 to 17.3 + 1.4 kg/m(2). Almost a fourth (23.6%) of the patients showed reliable changes, and 44.7% showed clinically significant changes (EDI-2). BMI change did not significantly differ between those with reliable or clinically significant change or no reliable change in EDI-2. Length of stay, depression and body dissatisfaction were negative predictors of a clinically significant change. Inpatient treatment is effective in about two thirds of adolescents with AN and should be considered when outpatient treatment fails. About one third of patients showed significant weight gain, but did not improve regarding overall ED symptomatology. Future studies should focus on treatment strategies for non-responders.

Individuals with anorexia nervosa (AN) and bulimia nervosa (BN) show emotion regulation deficits. While individuals with BN use binge eating to regulate negative affect, individuals with restricting-type AN may use self-starvation for this purpose. The current study examined the emotion regulatory

Objective We report on the long‐term outcome of males compared to females treated for anorexia nervosa (AN) or bulimia nervosa (BN). Methods A total of 119 males with AN and 60 males with BN were reassessed 5.8 ± 4.6 and 7.5 ± 5.9 years (respectively) after treatment and compared to matched female patients. Results At follow‐up, males with AN had a higher body weight than females. For AN, remission rates (40% males vs. 41% females) did not differ at follow‐up. And at follow‐up, more males (34%) than females (19%) had an eating disorder not otherwise specified (ED‐NOS; p < .01). At follow‐up of AN, there was no binge‐eating disorder (BED) and obesity was rare. For BN, remission rates (44% males vs. 50% females) and frequency of AN, BN, BED and ED‐NOS did not differ at follow‐up. Males with AN scored lower than females at follow‐up on most subscales of the Eating Disorder Inventory (EDI) and on somatization, obsessive–compulsive symptoms, and depression (Brief Symptom Inventory). Males with BN scored lower than females with BN on perfectionism and higher on interpersonal distrust (EDI) at follow‐up. Discussion Results from the scarce literature on males with ED are inconclusive regarding longer term outcome. In the present study, males with AN showed a slightly better outcome than females. In BN, outcome was about the same in males and females. According to our study, existing treatment is equally effective in both males and females. Additional research on the need of gender‐specific diagnosis and therapy is required.

Objective Different subtypes of eating disorders (ED) show dysfunctional eating behaviors such as overeating and/or restriction in response to emotions. Yet, systematic comparisons of all major EDs on emotional eating patterns are lacking. Furthermore, emotional eating correlates with body mass index (BMI), which also differs between EDs and thus confounds this comparison. Method Interview‐diagnosed female ED patients (n = 204) with restrictive (AN‐R) or binge‐purge anorexia nervosa (AN‐BP), bulimia nervosa (BN), or binge‐eating disorder (BED) completed a questionnaire assessing “negative emotional eating” (sadness, anger, anxiety) and “happiness eating.” ED groups were compared to BMI‐matched healthy controls (HCs; n = 172 ranging from underweight to obesity) to exclude BMI as a confound. Results Within HCs, higher BMI was associated with higher negative emotional eating and lower happiness eating. AN‐R reported the lowest degree of negative emotional eating relative to other EDs and BMI‐matched HCs, and the highest degree of happiness eating relative to other EDs. The BN and BED groups showed higher negative emotional eating compared to BMI‐matched HCs. Patients with AN‐BP occupied an intermediate position between AN‐R and BN/BED and reported less happiness eating compared to BMI‐matched HCs. Discussion Negative emotional and happiness eating patterns differ across EDs. BMI‐independent emotional eating patterns distinguish ED subgroups and might be related to the occurrence of binge eating versus restriction. Hence, different types of emotional eating can represent fruitful targets for tailored psychotherapeutic interventions. While BN and BED might be treated with similar approaches, AN‐BP and AN‐R would need specific treatment modules.

The study examines the effectiveness of home treatment in 70 children and adolescents (aged 6-17 years) with heterogeneous psychiatric disorders. Home treatment was offered to parents/children as an alternative to inpatient treatment (no randomized group assignment). Interventions were carried out by psychiatric nurses (n = 38) and medical students (n = 32) under the supervision of experienced child psychiatrists. Assessment of treatment effects was based on a structured parent interview and parents', children's and therapists' ratings of various aspects of psychosocial functioning. Pre- or post-treatment comparisons indicate significant improvement of psychiatric symptoms, severity of the disorder, and psychosocial adjustment after three months of home-based interventions. Outcome of behavioral interventions carried out by experienced nurses was superior, compared to treatment effects achieved by advanced medical students. Post-treatment comparison of home-based (n = 70) and inpatient-based (n = 35) treatment effects suggests that inpatient treatment all in all was more effective. At one-year follow-up, however, the effects of home treatment were maintained in a higher number of patients, compared to the stability of effects seen after psychiatric hospitalization. Thus, home treatment appears to be an effective treatment setting. Motivation and compliance of patient and parents, and high skills of the therapists are key ingredients for the success of a home-based treatment program.