Premature termination of treatment in an inpatient eating disorder programme

Masson, Philip; Perlman, Christopher M.; Ross, Stuart A.; Gates, April L.

doi:10.1002/erv.762

Cited by 36 publications

(30 citation statements)

References 25 publications

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“…0,6% [Machado et al, 2007] vergleichsweise niedrig liegen, ist die Bedeutung einer solchen Diagnose durch die gravierenden bis sogar tödlichen Konsequenzen bedingt [Nielsen, 2001;Mitchell und Crow, 2006]. Gleichzeitig ist die Prognose einer Behandlung für AN und BN bisher eher schlecht: Hohe Rückfallraten [Carter et al, 2009] und chronische Verläufe [Berkman et al, 2007] sowie unbefriedigende Ergebnisse in Psychotherapien und hohe Drop-out-Raten [Bandini et al, 2006;Masson et al, 2007] sind keine Seltenheit bei Patientinnen mit Essstörungen.…”

Section: Hintergrundunclassified

Explizite Lebensziele von Patientinnen mit Anorexia und Bulimia nervosa

et al. 2012

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Hintergrund: Die Identifizierung und Förderung expliziter Ziele hat sich in der Forschung für die Behandlung verschiedener Patientengruppen als hilfreich erwiesen. Hierbei sind insbesondere potenzielle Auswirkungen von Lebenszielen auf die Psychopathologie bzw. psychische Gesundheit sowie auf die Therapiemotivation zu nennen. Die Rolle individueller Lebensziele ist für Frauen mit Essstörungen bisher allerdings nicht untersucht worden, weshalb die vorliegende Studie diese Forschungslücke schließen möchte und Lebensziele bei Frauen mit Anorexia nervosa (AN) und Bulimia nervosa (BN) untersucht. Methoden: Patientinnen mit AN (n = 27) und BN (n = 20) sowie gesunde Kontrollprobandinnen (n = 56) bearbeiteten eine idiographisch orientierte Frage bezüglich ihrer expliziten Lebensziele. Die Striving Instrumentality Matrix wurde zur Messung von Zielkonflikten bzw. der Instrumentalität eigener Ziele eingesetzt. Mit einer Kurzversion des Inkongruenzfragebogens wurde das Ausmaß der Zielumsetzung erfasst. Ergebnisse: Patientinnen mit AN und BN verfolgen im Wesentlichen die gleichen Ziele wie gesunde Kontrollprobandinnen. Obwohl Frauen mit Essstörungen ihren Zielen eine höhere Instrumentalität zuschrieben als gesunde Frauen (p < 0,001), wiesen sie deutliche Defizite in der Umsetzung motivationaler Ziele auf (p < 0,001). Schlussfolgerungen: Mögliche Ursachen dafür, dass Patientinnen mit AN und BN den Einfluss ihrer Ziele untereinander förderlicher beurteilten als gesunde Frauen, werden diskutiert. Da Patientinnen mit Essstörungen deutliche Defizite in der Umsetzung ihrer Ziele aufwiesen, sollte insbesondere die Realisierung persönlicher Ziele in der Behandlung von Essstörungen stärker gefördert werden.

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Section: Hintergrundunclassified

Explizite Lebensziele von Patientinnen mit Anorexia und Bulimia nervosa

et al. 2012

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“…Taxas de abandono do tratamento para transtornos alimentares variam entre 20,2% a 49,6% para anorexia nervosa e entre 15 a 30% para a bulimia nervosa (Mahon, 2000;Wallier et al, 2009). Quando falamos estritamente sobre abandono do tratamento hospitalar para esses transtornos encontramos taxas de abandono entre 20 e 51% para a anorexia nervosa (Masson et al, 2007;Woodside et al, 2004) e entre 4,8 e 18,42% para a bulimia nervosa (Zeeck et al, 2009;Masson et al, 2007).…”

Section: Transtornos Alimentares E Abandono Do Tratamentounclassified

“…Muitas pesquisas não encontraram relação alguma entre tais variáveis (Zeeck et al 2004, Franzen et al, 2004Treat et al, 2005;Masson et al, 2007). Arcelus e Button (2007) (Mahon et al, 2001b).…”

Section: Transtornos Alimentares E Abandono Do Tratamentounclassified

“…Arcelus e Button (2007) (Mahon et al, 2001b). Outras pesquisas também não encontraram a idade como um fator de risco para o abandono do tratamento para TA (Franzen et al, 2004;Masson et al, 2007;Dalle Grave et al, 2008 completaram o tratamento para a anorexia nervosa (Björck et al 2008;Björk et al 2009). …”

Section: Transtornos Alimentares E Abandono Do Tratamentounclassified

“…Grande parte das pesquisas que investigou esta relação, não encontrou diferenças significativas entre as médias de idade entre quem completou o tratamento ou decidiu interrompê-lo sem a concordância médica seja esse tratamento oferecido na modalidade ambulatorial (Waller, 1997;Steel et al, 2000;Fassino et al, 2002;Fassino et al, 2003;Grave; 2008) hospitalar (Zeeck et al, 2005;Surgenor et al, 2004;Masson et al, 2007), em hospital -dia (Franzen et al, 2004), ou para adolescentes (Lock et al, 2006;Hoste et al, 2007).…”

Section: Análise Multivariadaunclassified

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Fatores de risco para o abandono do tratamento hospitalar para transtorno alimentares

Carvalho¹

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SUMMARY/ABSTRACTCarvalho, LSL. Risk factors for dropping out of inpatient treatment for eating disorers [Dissertação]. São Paulo, "Faculdade de Medicina, Universidade de São Paulo"; 2013.INTRODUCTION: Although is a frequent event, there is no consensus on what factors would be involved in the dropout of treatment for eating disorders. This study aimed to identify risk factors for the dropout of an inpatient treatment for anorexia nervosa and bulimia nervosa. Aspects previous to the hospitalization, clinical features present at the admission and factors related to the period of the inpatient treatment of patients who dropped out and completed treatment were compared. METHODS: We performed a retrospective study, case-control, with the dropout of the treatment being considered the interest condition. Medical records of female patients admitted to a specialized ward in treating anorexia nervosa and bulimia nervosa between the years 2005 and 2010 were reviewed. RESULTS: A total of 259 admissions and 178 patients, research subjects were 103 women, of which 83 completed treatment and 20 dropped out, resulting in a dropout rate of treatment of 19.42%. For the statistical treatment of the data was performed univariate analysis with subsequent multivariate logistic regression with backward stepwise selection analysis of the variables considered significant. In univariate analysis, professional removal due to illness severity, existence of affective relationship, lower BMI at admission, admissions motivated by low weight, diagnosis of anorexia nervosa and existence of purging behaviors (present in all patients who dropped out the treatment) were considered as factors related to dropout treatment. After conducting the logistic regression, we found that patients at admission who were removed from the job due to the illness severity, maintained a romantic relationship and were hospitalized due to low weight were more likely to dropout the treatment. CONCLUSIONS: In this sample, the dropout of treatment was influenced by sociodemographic factors (professional removal due to illness severity and existence of a romantic relationship), for diagnostic variables (diagnosis of anorexia nervosa and purging symptoms) and aspects of symptom severity (lower BMI and hospitalization motivated by low weight). These results lead us to the egosyntonic character of eating disorders, especially anorexia nervosa, and bring a paradox: patients that on admission showed more severe symptoms of the Eating Disorder (with lower weight and disabled to work) were more likely to dropout of the treatment. Although it has several limitations, mainly due to the retrospective design, the present research is the first study of dropout of inpatient treatment for eating disorders held in Brazil. It is suggested to run with prospective investigations to confirm or refute our findings.

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Termination of Psychotherapy

O’Donohue

Snipes

2015

The Encyclopedia of Clinical Psychology

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Termination refers to the ending of a period of psychotherapy. There has been a wide variety of views on its significance and how it ought to be conducted. Most termination seems to be patient initiated (i.e., the result of the client not showing up for a scheduled session). Termination can also depend on a number of variables, such as the theoretical orientation of the therapist, nature of the client problem, length of treatment, degree of success of therapy, personality characteristics of the client and therapist, and cost considerations. In addition, termination is sometimes associated with the need for relapse prevention and appropriate attention to continuity of care. Finally, the APA Ethical Principles require that termination occur when therapy is not beneficial or likely to be beneficial, when therapy is harming the client, or when there is harm or threat of harm to the therapist.

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Premature termination of treatment in an inpatient eating disorder programme

Cited by 36 publications

References 25 publications

Explizite Lebensziele von Patientinnen mit Anorexia und Bulimia nervosa

Explizite Lebensziele von Patientinnen mit Anorexia und Bulimia nervosa

Fatores de risco para o abandono do tratamento hospitalar para transtorno alimentares

Termination of Psychotherapy

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