Effectiveness of day hospital treatment for anorexia nervosa and bulimia nervosa

Abstract

The aim of this observational study was to examine the short-term effectiveness of a structured, largely manualised day hospital treatment, as well as the stability of short-term effects in patients with anorexia nervosa (AN) and bulimia nervosa (BN). Eighty-three patients, 47 with AN and 36 with BN, were assessed at pre-treatment, at the end of the day hospital treatment and at follow-up approximately one year after post-treatment. Outcome measures were body mass index (BMI), disturbed eating attitudes and behaviours assessed by the Eating Disorder Inventory (EDI), frequency of bingeing and purging, and general psychopathology assessed by the Symptom Checklist-90 (SCL-90). At the end of the day hospital treatment, significant improvements could be found on all outcome variables (frequency of binge eating/vomiting/laxative abuse, BMI and core EDI-subscales 'drive for thinness'/'bulimia'/'body dissatisfaction'). Effect sizes were generally large (.74 > d < 2.44). The effects were maintained or improved until follow-up (18 months). At follow-up, 40.2% of AN patients and 40.4% of BN patients could be classified as remitted. General psychopathological impairment was also significantly reduced at post-treatment and maintained until follow-up. The results demonstrate both the short-term effectiveness and long-term stability of day hospital treatment in a large sample of patients with anorexia and BN.

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

“…This pattern is particularly signifi cant given the more 'chronic' nature of the sample who were older, with a higher incidence of binge-eating and purging than previous samples (Fichter et al, 2006;Fittig, Jacobi, Backmund, Gerlinghoff, & Wittchen, 2008). The number of married patients is also of signifi cance given the role that marital interaction problems may play in the maintenance of eating disorders (Vandereycken, 1995).…”

Identification and Management of Eating Disorders in Children and Adolescents

“…Evaluation of day-treatment programs has been characterized by small samples and the difficulty in undertaking randomized controlled trials. 113 Still, short-term outcomes have generally been reported to be good. 110,113,114 A recent study that used a range of outcome measures, including BMI and measurement of binge-purge behavior, demonstrated day treatment to be highly effective in the treatment of both restrictive and binge-purge AN and BN.…”

“…113 Still, short-term outcomes have generally been reported to be good. 110,113,114 A recent study that used a range of outcome measures, including BMI and measurement of binge-purge behavior, demonstrated day treatment to be highly effective in the treatment of both restrictive and binge-purge AN and BN. Furthermore, these results were sustained or improved over 18 months of follow-up.…”

The Eating Disorder Inventory in the screening for DSM-5 binge eating disorder

“…The Eating Disorder Inventory (EDI) (Garner, 1991) has been frequently used as an eating disorder screening tool (Friborg, Clausen, & Rosenvinge, 2013;Jacobi, Abascal, & Taylor, 2004;Segura-Garcia et al, 2015) and measure of treatment response (Brambilla et al, 2009;Danielsen & Ro, 2012;Fittig, Jacobi, Backmund, Gerlinghoff, & Wittchen, 2008;Hagman et al, 2011;Lammers, Vroling, Ouwens, Engels, & van Strien, 2015). It is available in many languages and discriminates well between eating disorder patients and both psychiatric and normal control subjects (Nevonen, Clinton, & Norring, 2006).…”