The outcome of treatment for anorexia nervosa inpatients who required urgent hospitalization

Abstract

BackgroundThis study was done to determine which psychosocial factors are related to the urgent hospitalization of anorexia nervosa patients (AN) due to extremely poor physical condition and to evaluate their outcome after inpatient treatment.Methods133 hospitalized AN patients were classified into an urgent hospitalization (n = 24) or a planned hospitalization (n = 109) group. Multiple regression analysis was done of clinical features, body mass index (BMI), psychological tests [The Minnesota Multiphasic Personality Inventory (MMPI), alexithymia, relationship with parents, and the Eating Disorder Inventory (EDI)]. The effectiveness of treatment was prospectively determined two years after discharge by the Global Clinical Score (GCS). The hospitalized weight gain and the frequency of outpatient visits were evaluated.ResultsOf the factors assessed, only BMI at admission was related to the necessity of urgent hospitalization (β = − 1.063, P = 0.00). The urgent group had significantly more weight loss after discharge and poorer social adaptation on the GCS, even when the patient had a sufficient increase in body weight during inpatient treatment and an equivalent number of outpatient consultations.ConclusionNone of the parameters of the psychosocial tests studied were significantly different between the groups. The outcome of the urgent group was poor. Two years after discharge they had difficulty maintaining weight and continued to have poor social adaptation.

Rehospitalization and “Revolving Door” in Anorexia Nervosa: Are There Any Predictors of Time to Readmission?

“…This is of importance since our sample was composed of individuals with extreme AN (BMI < 15) facing an acute phase of the disorder. Such a difficult condition is particularly challenging in the light of data on unfavorable outcomes for those who require emergency hospitalizations (58) and for whom no pharmacological agents showed effectiveness (59). In fact, these patients experience a very acute phase of AN without receiving the recommended motivational preparation and engagement performed when hospitalizations are planned instead of required because of a life-threatening emergency.…”

Etiske perspektiver i behandling av spiseforstyrrelser

“…Sykehuset og døgnenheten vil vaere interessert i å forebygge akutte eller ufrivillige innleggelser, som kan utgjøre en større belastning for alle involverte (Kawai et al, 2014;Simon et al, 2005). Samtidig kan langvarig poliklinisk behandling opprettholde en spiseforstyrrelse og bidra til et kronisk forløp som er ressurskrevende over tid.…”

Research prospects in BioPsychoSocial medicine: new year reflections on the “Cross-Boarder Dialogue” paradigm

“…Kawai et al shed some light on this important issue in asking what psychosocial factors are associated with immediate (urgent) inpatient admission of patients suffering from anorexia nervosa [ 14 ]. The group analyzed a total sample of 133 patients that were either urgently admitted or scheduled for planned admission.…”

“…Given this finding one could ask whether e.g. a step-down approach for the severely-ill patient group might be advisable, where patients receive day-patient care following intense inpatient treatment to facilitate the setting transfer from inpatient to ambulatory care [ 14 ].…”