Short-term outcome of anorexia nervosa in adolescents after inpatient treatment: a prospective study

Salbach‐Andrae, Harriet; Schneider, Nora; Seifert, Katja; Pfeiffer, E. F.; Lenz, Klaus; Lehmkuhl, Ulrike; Korte, Alexander

doi:10.1007/s00787-009-0024-9

Cited by 40 publications

(34 citation statements)

References 30 publications

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“…In fact, BN patients are usually more motivated to seek treatment and change than both AN and subthreshold-AN individuals, mostly if chronic [37], and there is general consensus that binge-purging AN individuals show an unfavorable outcome [56]. Another recent study suggested indeed a more positive prognosis for EDNOS individuals; they seemed to achieve a more rapid and stable remission and showed indexes of higher motivation when compared to individuals affected by a full diagnosis [39], providing further support to data already known in literature [33,46].…”

Section: Resultsmentioning

confidence: 99%

Resistance to treatment and change in anorexia nervosa: a clinical overview

et al. 2013

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BackgroundCurrent literature on Eating Disorders (EDs) is devoid of evidence-based findings providing support to effective treatments, mostly for anorexia nervosa (AN). This lack of successful guidelines may play a role in making these disorders even more resistant. In fact, many individuals do not respond to the available treatments and develop an enduring and disabling illness. With this overview we aimed to highlight and discuss treatment resistance in AN – with an in-depth investigation of resistance-related psychological factors.A literature search was conducted on PubMed and PsychINFO; English-language articles published between 1990 and 2013 investigating the phenomenon of resistance to treatment in AN have been considered.DiscussionThe selected papers have been then grouped into four main thematic areas: denial of illness; motivation to change; maintaining factors and treatment outcome; and therapeutic relationship. Eating symptomatology was found to only partially explain resistance to treatment. The role of duration of illness has been questioned whilst some maintaining factors seemed promising in providing a useful framework for this phenomenon. Emotive and relational aspects have been investigated on their role in resistance as well as therapists’ countertransference.SummaryRemarkably there has been little research done on resistance to treatment in the ED field, in spite of its clinical relevance. Motivation, insight and subjective meaning of the illness can be useful tools to manage the resistance phenomenon when coupled with a wider approach. The latter enables the therapists to be aware of their role in the therapeutic alliance through countertransference aspects and to consider the EDs as disorders of the development of both personality and self, entailing severe impairments as regards identity and relationships.

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Section: Resultsmentioning

confidence: 99%

Resistance to treatment and change in anorexia nervosa: a clinical overview

et al. 2013

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“…This finding is in line with studies that include clinic-referred samples [26,58] but is in contrast to studies that include community samples [27,38]. It is likely that in clinically referred children, parents are more concerned about their children's problems than children themselves, thus, resulting in higher parent ratings.…”

Section: Discussionsupporting

confidence: 49%

“…For instance, in clinical settings, parents tend to report more problem behaviors than children [1,25,26], whereas in non-clinical settings, children often report more problems than parents [27]. Children in clinical settings are most often referred by their parents and hence, it is likely that parents tend to endorse more problems than their children.…”

Section: Factors Influencing Parent-child Agreement On Externalizing mentioning

confidence: 91%

“…Studies reporting gender effects on parent-child agreement on child behavioral and emotional problems are also mixed [9]. Some studies have found a significant relationship between the child's gender and informant discrepancies [1,7,8,12,26,[35][36][37]. For example, Kazdin et al [38] found that boys showed less agreement with their parents regarding a variety of psychiatric symptoms compared to girls.…”

Section: Factors Influencing Parent-child Agreement On Externalizing mentioning

confidence: 93%

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Agreement Between Parent- and Self-Reports of Psychopathic Traits and Externalizing Behaviors in a Clinical Sample

Ooi

Glenn

Ang

et al. 2016

Child Psychiatry Hum Dev

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A number of studies have identified discrepancies in informant ratings of externalizing behaviors in youth, but it is unclear whether similar discrepancies exist between informants when rating psychopathic traits. In this study, we examined parent-child agreement on ratings of both psychopathic traits and externalizing behaviors, and examined the factors that influence agreement in both of these domains. A total of 282 children between 7 and 16 years (M = 10.60 years, SD = 1.91) from an outpatient child psychiatric clinic participated in this study. Our findings revealed low levels of parent-child agreement on these measures (ICC values ranging from .02 to .30 for psychopathic traits; ICC values ranging from .09 to .30 for externalizing behaviors). In addition, our findings did not support the moderating effects of child's age, gender, clinical diagnosis, informant, and parental conflict on the relationship between parent- and child-ratings of psychopathic traits and externalizing behaviors. Further research is needed to better understand how parents and child reports of child's externalizing behaviors and psychopathic traits are similar and/or different from one another and factors that influence these agreements.

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“…28 This wide range rates could be explained not only by the absence of commonly accepted outcome criteria, but also by different study methodologies or DSM diagnostic criteria along the years. 27 On the other hand, reports on long-term course of AN in adults suggested that recovery increased with longer follow-up periods 29 reaching almost half of the surviving patients, while about 20% remained chronically ill, 16 so that we considered our mean follow-up period (1.29 years -approximately one year and four months) a short term to successfully achieve and/or interpret conclusions on the global AN outcome.…”

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confidence: 99%

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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Short-term outcome of anorexia nervosa in adolescents after inpatient treatment: a prospective study

Cited by 40 publications

References 30 publications

Resistance to treatment and change in anorexia nervosa: a clinical overview

Resistance to treatment and change in anorexia nervosa: a clinical overview

Agreement Between Parent- and Self-Reports of Psychopathic Traits and Externalizing Behaviors in a Clinical Sample

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

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