Inpatient weight curve trajectory as a prognostic factor among adolescents with anorexia nervosa: a preliminary report

Adar, Avnon; Orkaby, Naomi; Hadas, Arik; Berger, Uri; Klomek, Anat Brunstein; Fennig, Silvana

doi:10.1007/s40519-017-0415-8

Cited by 14 publications

(12 citation statements)

References 29 publications

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“…Our data showed a rate of readmission to patients with AN similar to the ones described in another study (34%) (Avnon et al, 2017). A possible explanation arises from the low median LoS of hospitalizations related to AN, that has been increasing during the study period.…”

Section: Clinical Features: In-hospital Mortality; Attempt Of Suicisupporting

confidence: 87%

“…The possible existence of lower clinical thresholds for readmission can also explain the present readmission rate in our study (Avnon et al, 2017;Currin, Schmidt, Treasure, & Jick, 2005;Holland, Hall, Yeates, & Goldacre, 2016;Lopez-de-Andres et al, 2010)(Avnon et al, 2017;Currin, Schmidt, Treasure, & Jick, 2005;Holland, Hall, Yeates, & Goldacre, 2016;Lopez-de-Andres et al, 2010)…”

supporting

confidence: 56%

“…AN is associated with higher rates of relapse in adolescents, even with inpatient treatment. The probability of a relapse seems to be less significant in patients who do not present a re-hospitalization within first year after discharge (Avnon et al, 2017).…”

Section: Introductionmentioning

confidence: 94%

“…The possible existence of lower clinical thresholds for readmission can also explain the present readmission rate in our study. (Avnon et al, 2017;Currin, Schmidt, Treasure, & Jick, 2005;Holland, Hall, Yeates, & Goldacre, 2016;Lopez-de-Andres et al, 2010).…”

Section: Clinical Features: In-hospital Mortality; Attempt Of Suicimentioning

confidence: 99%

“…According to some authors, AN has the highest mortality rate of psychiatric disorders (de Oliveira, Colton, Cheng, Olmsted, & Kurdyak, 2017). The probability of a relapse seems to be less significant in patients who do not present a re-hospitalization within first year after discharge (Avnon et al, 2017). evidence showed that AN-patients were 18.1 times more likely to die due to suicide than general population.…”

Section: Introductionmentioning

confidence: 96%

See 4 more Smart Citations

Eating disorders—Related hospitalizations in Portugal: A nationwide study from 2000 to 2014

Cruz

Gonçalves‐Pinho

Santos

et al. 2018

Intl J Eating Disorders

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Introduction: Recent evidence suggests that incidence of Anorexia nervosa (AN) has remained stable over the last decades in Western Europe, while decreasing for Bulimia nervosa (BN). It is well-known that most individuals with an ED (Eating disorder) do not seek medical treatment.Objective: The present study analyses hospitalizations related with EDs held in mainland Portuguese public hospitals between 2000 and 2014.Method: A retrospective observational study was performed gathering all inpatient episodes with primary or secondary diagnosis of ED. Number of patients, gender, mean age at discharge, suicide-attempts related hospitalizations, in-hospital mortality, length of stay, and mean charges were analyzed.Results: There were a total of 4,485 hospitalizations with an associated ED. AN was the most frequent ED (n = 2,806). Suicide attempt-related hospitalizations were most common among patients with BN (10.1% of BN hospitalizations) or AN (5.2% of AN hospitalizations).Discussion: AN has higher in-hospital mortality than BN. We observed a higher proportion of suicide related hospitalizations in BN when compared to AN. Although pica, rumination disorder, and psychogenic vomiting represent a smaller portion of all EDs, this study was the first to describe hospitalization trends for this set of EDs for a 15-year period, to the best of our knowledge.

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Section: Clinical Features: In-hospital Mortality; Attempt Of Suicisupporting

confidence: 87%

supporting

confidence: 56%

Section: Introductionmentioning

confidence: 94%

Section: Clinical Features: In-hospital Mortality; Attempt Of Suicimentioning

confidence: 99%

Section: Introductionmentioning

confidence: 96%

See 3 more Smart Citations

Eating disorders—Related hospitalizations in Portugal: A nationwide study from 2000 to 2014

Cruz

Gonçalves‐Pinho

Santos

et al. 2018

Intl J Eating Disorders

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An overview and investigation of relapse predictors in anorexia nervosa: A systematic review and meta‐analysis

de Rijk,

Almirabi,

Robinson

et al. 2023

Intl J Eating Disorders

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ObjectiveAn extensive number of predictors has been examined across the literature to improve knowledge of relapse in anorexia nervosa (AN). These studies provide various recovery and relapse definitions, follow‐up durations and relapse rates. The current study summarizes these values and predictors of relapse in AN in a review and meta‐analysis.MethodThe study was executed according to PRISMA guidelines. Different databases were searched and studies in which participants did not receive an official clinical diagnosis were excluded. A quality analysis was performed using the National Institute of Health's Study Quality Assessment Tool. Random‐effects meta‐analyses were conducted to summarize data.ResultsDefinitions of relapse and recovery were diverse. During an average follow‐up period of 31 months an average relapse rate of 37% was found. Predictive variables from 28 studies were grouped in six categories: age and sex, symptoms and behaviors, AN subtype and duration, weight or weight change, comorbidity, and personality. The studies were characterized by non‐significant and contradictory results. Meta‐analyses were performed for the predictors age, AN duration, pre‐treatment BMI, post‐treatment BMI and depression. These yielded significant effects for post‐treatment BMI and depression: higher pre‐treatment depression (SMD = .40 CI [.21–.59] and lower post‐treatment BMI (SMD = −.35 CI [−.63 to −.07]) increased relapse chances in AN.DiscussionOur results emphasized a lack of sufficiently powered studies, consistent results, and robust findings. Solely post‐treatment BMI and pre‐treatment depression predicted relapse. Future research should use uniform definitions, larger samples and better designs, to improve our understanding of relapse in AN.Public significanceKnowledge about predictors is important to understand high relapse rates. Our study performed a review and meta‐analysis of relapse predictors in AN. Related to the heterogeneity in studies examining predictors, an overview of relapse and recovery definitions, follow‐up durations and relapse rates for AN was provided. Significant effects were found for post‐treatment BMI and pre‐treatment depression. More studies with uniform definitions are needed to improve clinical implications.

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‘Therapists in action’—Home treatment in adolescent anorexia nervosa: A stepped care approach to shorten inpatient treatment

Herpertz‐Dahlmann

Borzikowsky

Altdorf

et al. 2020

Euro Eating Disorders Rev

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It was the aim of this pilot study to apply a novel eating disorder (ED)-specific home treatment (HoT) to adolescents with anorexia nervosa (AN) and to investigate its feasibility, effects and safety.Method: Twenty-two patients consecutively admitted to the hospital and fulfilling DSM-5 criteria for typical or atypical AN received HoT after 4-8 weeks of inpatient treatment. During the first two months of HoT, the patient and her family were visited on average three to four times per week, during the third and fourth months of HoT once or twice a week by a multi-professional team. Body mass index, ED and general psychopathology, quality of life and treatment satisfaction were assessed in the patients at admission, start and end of HoT and the 1-year follow-up as well as carers' skills and burden. Results: The majority of patients successfully achieved target weight within HoT and maintained it successfully at the 1-year follow-up. ED and general psychopathology in the patients and carers' skills improved significantly associated with a high treatment satisfaction.Conclusions: HoT seems to be a promising new tool to improve outcome in adolescent AN and to reduce time of hospitalisation. Larger randomised controlled trials are needed to generalise these results. K E Y W O R D S adolescence, anorexia nervosa, community-based treatment, home treatment, outcome [Correction added on 17 July 2020, after first online publication: Projekt Deal funding statement has been added.] Astrid Dempfle and Brigitte Dahmen contributed equally to this study.

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Inpatient weight curve trajectory as a prognostic factor among adolescents with anorexia nervosa: a preliminary report

Abstract: Variations in weight restoration during inpatient treatment may be used to identify patients at risk for relapse. NCV can alert clinicians to initiate early relapse prevention interventions before discharge. Level of Evidence Level III, cohort study.

Cited by 14 publications

References 29 publications

Eating disorders—Related hospitalizations in Portugal: A nationwide study from 2000 to 2014

Eating disorders—Related hospitalizations in Portugal: A nationwide study from 2000 to 2014

An overview and investigation of relapse predictors in anorexia nervosa: A systematic review and meta‐analysis

‘Therapists in action’—Home treatment in adolescent anorexia nervosa: A stepped care approach to shorten inpatient treatment

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