The place of inpatient care in the treatment of anorexia nervosa: Questions to be answered

Vandereycken, Walter

doi:10.1002/eat.10223

Cited by 79 publications

(63 citation statements)

References 68 publications

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“…As outlined in the first part of the discussion, subtypes of AN with low weight and body concerns have already been identified in previous studies [15,38] . This is a monocenter study, and the barriers or routes to hospitalization may vary according to culture and the availability of services [48] , which may also limit the generalizability of our results, but implies that the selected patients were assessed using the same instruments and by similar criteria which we checked by showing that the profile of patients had not changed significantly over the study period. This study concerned only women, and thus results cannot be extrapolated to the small population of men with ED.…”

Section: Discussionmentioning

confidence: 99%

Outcomes of Empirical Eating Disorder Phenotypes in a Clinical Female Sample: Results from a Latent Class Analysis

Dechartres¹,

Huas²,

Godart³

et al. 2010

Psychopathology

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Background/Aims: To empirically classify phenotypes of eating disorders (ED) using latent class analysis (LCA), and to validate this classification based on clinical outcomes. Methods: LCA was applied to 968 inpatients. The resultant classes were validated by clinical outcomes including mortality. Results: A 5-class solution showed the best fit. The symptoms of latent class 1 (LC1; 26% of the sample) resembled anorexia nervosa (AN), bingeing-purging (AN-B/P) subtype; those of LC2 (23%) resembled bulimia nervosa; those of LC3 (11%) were close to AN-B/P without weight and body concerns; those of LC4 resembled restrictive anorexia nervosa (RAN) without weight and body concerns, and those of LC5 RAN. A history of hospitalization for ED was significantly more frequent for LC3 and LC4. The lowest BMI at admission were presented in LC4. LC1 showed the highest level of psychological disturbances and LC4 the lowest. LC3 and LC4 differed from LC1 and LC5 by higher percentages of treatment dropout (64.9 vs. 57.2 and 55.7 vs. 47.5%, respectively; overall p = 0.001). Survival rates tended to be different between the LC (p = 0.09). Conclusions: Subgroups of AN patients with low weight and body concerns seem more severe at hospitalization and more difficult to manage, with a higher rate of treatment dropout than the ‘typical’ AN patients.

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Section: Discussionmentioning

confidence: 99%

Outcomes of Empirical Eating Disorder Phenotypes in a Clinical Female Sample: Results from a Latent Class Analysis

Dechartres¹,

Huas²,

Godart³

et al. 2010

Psychopathology

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“…With engagement of characteristically ambivalent patients [15] critical to treatment success, and engagement dependent on acceptability of treatment, a thorough qualitative understanding of inpatient care from the patients' perspective is needed to optimise outcomes [29,30]. Aiming to contribute to the growing evidence base and inform service improvement locally we set out to describe the experiences of adults admitted to hospital for treatment of eating disorders.…”

Section: Introductionmentioning

confidence: 99%

Patients’ perspective on inpatient treatment for eating disorders: A mixed-methods study of satisfaction, experience of care and perceived helpfulness of components of treatment

Patterson¹,

Bellair²,

Jeffrey³

et al. 2017

Ment Health Addict Res

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“…It is recommended that young patients who still live with their family should get family treatment [1], but again, the research base is sparse and there is controversy about its interpretation [15,16]. Concerning service levels, there are opposing positions about the role of inpatient treatment in AN [17], ranging from statements pointing to dangers of hospitalization [18] and limiting it strictly to crisis intervention [1], to arguments stating that the reduction of hospital beds and shorter stays will cause more chronic courses and rehospitalizations [19] or recommending it as an important part of treatment [20]. …”

Section: Introductionmentioning

confidence: 99%

Psychological Treatment for Anorexia Nervosa: A Meta-Analysis of Standardized Mean Change

Hartmann

Weber²,

Herpertz³

et al. 2011

Psychother Psychosom

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Background: For the German treatment guidelines for eating disorders, the literature on psychological treatment of anorexia nervosa (AN) was reviewed systematically. As a common meta-analysis of randomized clinical trials proved to be impossible, a review of all available clinical trials was conducted, statistically integrating standardized mean change scores. Research questions comprised differential effects of therapeutic techniques and settings as well as determining which weight gains could be expected. Methods: After an extensive literature search, studies were selected, rated by 3 independent raters. Weight gain as the main outcome criterion was transformed into standardized mean change scores. Effect sizes were checked for homogeneity. Results: 57 studies containing 84 treatment arms and 2,273 patients could be integrated. Studies differed considerably in quality. The strongest bias identified was reporting selectively on completers or failures, versus intention-to-treat samples. No significant differences between effect sizes could be identified concerning treatment setting, technique or patient characteristics. If treatment time is taken into account, inpatient treatment produced a faster weight gain than outpatient treatment. Conclusion: The study describes weight gains which can be reached in outpatient and inpatient settings. It yielded no salient results speaking for a certain therapy technique, setting or procedure. Treatment guidelines for psychological treatment of AN still have to rely on lower level evidence.

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The place of inpatient care in the treatment of anorexia nervosa: Questions to be answered

Abstract: We will highlight important issues in the ongoing debate between economic demands and clinical challenges. Our goal is to stimulate critical reflections and systematic research.

Cited by 79 publications

References 68 publications

Outcomes of Empirical Eating Disorder Phenotypes in a Clinical Female Sample: Results from a Latent Class Analysis

Outcomes of Empirical Eating Disorder Phenotypes in a Clinical Female Sample: Results from a Latent Class Analysis

Patients’ perspective on inpatient treatment for eating disorders: A mixed-methods study of satisfaction, experience of care and perceived helpfulness of components of treatment

Psychological Treatment for Anorexia Nervosa: A Meta-Analysis of Standardized Mean Change

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