Influence of Attitudes towards Change and Self‐directness on Dropout in Eating Disorders: A 2‐Year Follow‐up Study

Rodríguez-Cano, Teresa; Beato-Fernández, Luís; Moreno, Luis Rojo; Vaz-Leal, Francisco J.

doi:10.1002/erv.2157

Cited by 16 publications

(21 citation statements)

References 26 publications

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“…The positive impact of treatment on motivation to change appears to have a long term effect, with nine of the 11 studies that included a follow‐up measure of motivation finding that improvements were maintained, or continued to increase, across all time points up to 2 years (Dean et al, ; Geller et al, ; Leung, Ma, & Russell, ; Leung, Ma, & Russell, ; Rodríguez‐Cano & Beato‐Fernández, ; Rodríguez‐Cano et al, ; Touyz et al, ; Wade, Treasure & Schmidt, , Pellizzer, unpublished). Only one study, Ackard et al (), found that motivation to change dropped below baseline over time.…”

Section: Resultsmentioning

confidence: 99%

“…Potential differences in the effect of interventions on motivation to change between different eating disorder diagnoses is difficult to ascertain as only two studies provided sub‐group analysis for motivational changes based on eating disorder type (Allen et al, ; Rodríguez‐Cano et al, ). However in both cases, while significant changes in motivation to change were found for all participants, the pattern of change was different between sub‐groups.…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Improving motivation to change amongst individuals with eating disorders: A systematic review

Denison-Day

Appleton

Newell

et al. 2018

Intl J Eating Disorders

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Improving motivation to change amongst individuals with eating disorders: A systematic review

Denison-Day

Appleton

Newell

et al. 2018

Intl J Eating Disorders

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“…Impairment in positive aspects, often neglected in research, is noteworthy as there is evidence that such deficits may be associated with chronicity or relapse in EDs (Espindola & Blay, 2009;Rodríguez-Cano, Beato-Fernandez, Moreno, & Vaz Leal, 2012) and in other psychiatric populations (Fava, 2012;Ryff, 2014). Moreover, the lack of differences in a couple of studies on self-liking and social functioning between remitted or recovered patients and healthy controls may warrant larger studies to support such findings.…”

Section: Discussionmentioning

confidence: 99%

Residual eating disorder symptoms and clinical features in remitted and recovered eating disorder patients: A systematic review with meta‐analysis

Tomba

Tecuta

Crocetti

et al. 2019

Intl J Eating Disorders

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Objective: In psychiatry, the presence of residual symptoms after treatment is linked to the definitions of remission and recovery. To identify the presence of residual eating disorder (ED) symptoms and associated non-ED clinical features in remitted and recovered EDs, the current systematic review with meta-analysis was performed.Method: A systematic review was conducted on residual ED symptoms and non-ED clinical features including comorbid psychopathology, neurophysiological functioning, cognitive functioning, and quality of life in ED patients considered remitted or recovered. To examine residual ED symptoms, meta-analyses were performed while considering age, study quality, remission, and recovery criteria strictness as moderators.Sensitivity, publication bias, and heterogeneity analyses were also conducted. Results: The 64 studies selected for the systematic review underscored the presence of residual ED symptoms in anorexia nervosa (AN) and bulimia nervosa (BN), and impairments and deficits in the additional features examined. From the 64 studies, 31 were selected regarding residual ED symptoms in AN for meta-analysis. Large effect sizes indicated that remitted/recovered AN patients reported significantly lower body mass index (Hedges' g = −0.62[−0.77, −0.46]) and significantly greater symptomatology in terms of ED examination-questionnaire (Hedges'g = 0.86 [0.48,1.23]) and ED inventory (Hedges' g = 0.94[0.64,1.24]) than healthy controls, independently of remission and recovery criteria strictness, age, and study quality. Discussion: The presence of residual ED symptoms in AN is quantitatively supported, whereas the presence of residual ED symptoms in BN should be further investigated. Data on binge-eating disorder are missing. Future research should use consistent, multicomponent, and standardized comparable indicators of recovery. ResumenObjetivo: En psiquiatría, la presencia de síntomas residuales después de tratamiento está ligado a las definiciones de remisión y recuperación. Para identificar la presencia de síntomas residuales del trastorno de la conducta alimentaria (TCA) y características clínicas no de TCA asociadas en pacientes remitidos y recuperados de TCAs, se realizó la presente revisión sistemática con meta-análisis.

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“…The lack of consensual definition of remission creates difficulties when comparing outcome data from treatment modalities and centers, so we emphasize the need for uniform adoption of remission definitions. 28 Furthermore, the high incidence of dropout as in the case of the majority of literature, 24,33 as well as in our study, largely decreases the power and generalization of the results.…”

Section: Resultsmentioning

confidence: 49%

“…23 Data from standard clinical practice reveal that dropout rates have not changed over the course of time, regardless of country or treatment modality, reaching 50% or more for both outpatient and inpatient samples. 24,25 In our program we had 55% dropout rate, 11.2% of which matching early dropouts, a favorable value compared to previous estimates among outpatient eating disorder services of 13 -32%. 26 We do not know exactly the major reasons for premature treatment termination of our patients but resistance to treatment and reluctance to recovery have been long recognized as key-problems in the treatment, as well as illness duration, treatment type and family variables.…”

mentioning

confidence: 83%

Treatment of Anorexia Nervosa: The Importance of Disease Progression in the Prognosis

et al. 2017

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RESUMOIntrodução: A anorexia nervosa é uma doença severa, geralmente crónica e potencialmente fatal, de etiologia complexa e caraterizada por restrição alimentar, sobrevalorização da importância do peso corporal e da imagem, medo intenso de ganho ponderal e distorção da imagem corporal. A anorexia nervosa está associada a altas taxas de mortalidade, suicídio e diminuição da qualidade de vida. O nosso objetivo é apresentar um programa de tratamento da anorexia nervosa de um hospital universitário português e determinar o impacto da duração da doença, antes da admissão, no outcome. A nossa hipótese é que pacientes com maior longevidade da doença apresentam piores prognóstico e outcome. Material e Métodos:A amostra incluiu dados de 169 pacientes vistos consecutivamente e pela primeira vez no Centro Hospitalar de São João, entre 2010 e 2015. Realizámos um estudo observacional retrospetivo, que incluiu os dados colhidos na admissão e durante o seguimento.Resultados: Dos doentes inicialmente selecionados, 14,8% alcançaram remissão total, 16% remissão parcial e 14,2% terminaram com exacerbação/estagnação da doença. A taxa de dropout foi 55% durante o nosso período de estudo. Encontrámos diferenças estatisticamente significativas relativamente ao outcome para diferentes tempos de duração da doença (p = 0,007).Discussão: Existem vários fatores frequentemente associados com mau outcome na anorexia nervosa. A interpretação dos resultados foi limitada pela alta taxa de dropouts e falta de critérios de definição consistentes. Conclusão:Os nossos resultados apoiam a ideia de que a duração da doença tem um papel preponderante no outcome e prognóstico da doença.Palavras-chave: Anorexia Nervosa/tratamento; Prognóstico; Progressão da Doença; Resultado do Tratamento ABSTRACT Introduction: Anorexia nervosa is a severe, usually chronic, life-threatening disease of complex etiology characterized by food restriction, overestimation of the importance of body weight and image, intense fear of weight gain and distortion of body image. Anorexia nervosa is associated with high rates of mortality, suicide and decreased quality of life. Our aim is to present an anorexia nervosa treatment program offered in a major university hospital in Portugal, and to determine the impact of illness duration before admission on the outcome. Our hypothesis is that patients with greater disease longevity may have worse prognosis and poorer outcome. Material and Methods:The sample included data from case records of 169 patients seen consecutively and for the first time at Centro Hospitalar São João, between 2010 and 2015. We performed a retrospective observational study which included data collected at admission and from later follow-up years.Results: From the initially selected patients, 14.8% reached total remission, 16% accomplished partial remission and 14.2% ended up with exacerbation/stagnation of the disease. The dropout rate was of 55% throughout our study period. We found significant differences on outcome rates between distinct illness duration grou...

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Influence of Attitudes towards Change and Self‐directness on Dropout in Eating Disorders: A 2‐Year Follow‐up Study

Abstract: The clinician's challenge is to help eating disorders patients to develop an unyielding sense of responsibility and self-acceptance, aimed to integrate the therapeutic choice into their own intrapersonal frame of goals.

Cited by 16 publications

References 26 publications

Improving motivation to change amongst individuals with eating disorders: A systematic review

Improving motivation to change amongst individuals with eating disorders: A systematic review

Residual eating disorder symptoms and clinical features in remitted and recovered eating disorder patients: A systematic review with meta‐analysis

Treatment of Anorexia Nervosa: The Importance of Disease Progression in the Prognosis

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