Short-term follow-up of adults with long standing anorexia nervosa or non-specified eating disorder after inpatient treatment

2004 ◽  
Vol 9 (1) ◽  
pp. 62-68 ◽  
Author(s):  
Ø. Rø ◽  
E. W. Martinsen ◽  
A. Hoffart ◽  
J. H. Rosenvinge
Keyword(s):  
Anorexia Nervosa ◽  
Eating Disorder ◽  
Inpatient Treatment ◽  
Short Term

scholarly journals Predictors of illness course and health maintenance following inpatient treatment among patients with anorexia nervosa

2020 ◽  
Vol 8 (1) ◽  
Author(s):  
Deborah R. Glasofer ◽  
Alexandra F. Muratore ◽  
Evelyn Attia ◽  
Peng Wu ◽  
Yuanjia Wang ◽  
...  
Keyword(s):  
Anorexia Nervosa ◽  
Eating Disorder ◽  
Inpatient Treatment ◽  
Weight Status ◽  
Self Report ◽  
Healthy Weight ◽  
Health Maintenance ◽  
Duration Of Illness ◽  
Clinical Impairment

Abstract Background Anorexia nervosa (AN) is a life-threatening psychiatric disorder associated with significant medical and psychosocial impairment. Hospital-based behavioral treatment is an effective intervention in the short-term. However, relapse rates following discharge are high and thus, there is a need to identify predictors of longitudinal outcome. The current study provides information regarding illness course and health maintenance among patients with AN over 5 years following discharge from an eating disorder inpatient unit. Methods Participants were individuals with AN who were discharged from a specialized, inpatient behaviorally-based unit. Prior to discharge, height and weight were measured and participants completed self-report measures of eating disorder severity and general psychopathology (depression, anxiety, harm avoidance). Participants were contacted annually for self-report measures of weight, eating disorder severity and clinical impairment. Outcome was defined by illness course (body mass index (BMI) and clinical impairment during the 5 years) and health maintenance (categories of weight and eating disorder symptom severity) across follow-up, using all available data. Linear mixed models were used to examine whether demographic and clinical parameters at discharge predicted BMI and clinical impairment over time. Additional analyses examined whether these variables significantly influenced an individual’s likelihood of maintaining inpatient treatment gains. Results One-hundred and sixty-eight individuals contributed data. Higher trait anxiety at discharge was associated with a lower BMI during follow-up (p = 0.012). There was a significant interaction between duration of illness and time, whereby duration of illness was associated with a faster rate of weight loss (p = 0.003) during follow-up. As duration of illness increased, there was a greater increase in self-reported clinical impairment (p = 0.011). Increased eating disorder severity at discharge was also associated with greater clinical impairment at follow-up (p = 0.004). Higher BMI at discharge was significantly associated with maintaining healthy weight across a priori BMI-based definitions of health maintenance. Conclusions Weight status (higher BMI) and duration of illness are key factors in the prognosis of AN. Higher weight targets in intensive treatments may be of value in improving outcomes.

Mixture Modeling to Characterize Anorexia Nervosa: Integrating Personality and Eating Disorder Psychopathology

2019 ◽  
pp. 107839031986202
Author(s):  
Karen M. Jennings ◽  
Lindsay P. Bodell ◽  
Ross D. Crosby ◽  
Ann F. Haynos ◽  
Jennifer E. Wildes
Keyword(s):  
Anorexia Nervosa ◽  
Eating Disorder ◽  
Latent Class ◽  
Clinical Presentation ◽  
Mixture Modeling ◽  
Eating Disorder Psychopathology ◽  
Personality Psychopathology ◽  
Latent Dimension ◽  
Eating Disorder Behaviors

BACKGROUND: Efforts to examine alternative classifications (e.g., personality) of anorexia nervosa (AN) using empirical techniques are crucial to elucidate diverse symptom presentations, personality traits, and psychiatric comorbidities. AIM: The purpose of this study was to use an empirical approach (mixture modeling) to test an alternative classification of AN as categorical, dimensional, or hybrid categorical–dimensional construct based on the co-occurrence of personality psychopathology and eating disorder clinical presentation. METHOD: Patients with AN ( N = 194) completed interviews and questionnaires at treatment admission and 3-month follow-up. Mixture modeling was used to test whether indicators best classified AN as categorical, dimensional, or hybrid. RESULTS: A four-latent class, one-latent dimension mixture model that was variant across groups provided the best fit to the data. Results suggest that all classes were characterized by low self-esteem and self-harming and suicidality tendencies. Individuals assigned to Latent Class 2 (LC2; n = 21) had a greater tendency toward being impulsive and easily angered and having difficulties controlling anger compared with those in LC1 ( n = 84) and LC3 ( n = 66). Moreover, individuals assigned to LC1 and LC3 were more likely to have a poor outcome from intensive treatment compared with those in LC4 ( n = 21). Findings indicate that the dimensional aspect within each class measured frequency of specific eating disorder behaviors but did not predict treatment outcomes. CONCLUSION: These results emphasize the complexity of AN and the importance of considering how facets of clinical presentation beyond eating disorder behaviors may have different treatment and prognostic implications.

Child psychiatric short-term inpatient treatment: CGAS as follow-up measure

1996 ◽  
Vol 27 (2) ◽  
pp. 93-104 ◽  
Author(s):  
Andre Sourander ◽  
Hans Helenius ◽  
Jorma Piha
Keyword(s):  
Inpatient Treatment ◽  
Short Term ◽  
Child Psychiatric

Outcome of severe anorexia nervosa patients receiving inpatient treatment in Japan: An 8-year follow-up study

2001 ◽  
Vol 55 (4) ◽  
pp. 389-396 ◽  
Author(s):  
Hideki Tanaka ◽  
Nobuo Kiriike ◽  
Toshihiko Nagata ◽  
Keisen Riku
Keyword(s):  
Anorexia Nervosa ◽  
Inpatient Treatment ◽  
Follow Up Study

Short-Term Follow-up After Brief Inpatient Treatment

1975 ◽  
Vol 26 (11) ◽  
pp. 741-744
Author(s):  
Catherine Harakal St. Clair
Keyword(s):  
Inpatient Treatment ◽  
Short Term

scholarly journals Randomised controlled feasibility trial of real versus sham repetitive transcranial magnetic stimulation treatment in adults with severe and enduring anorexia nervosa: the TIARA study

BMJ Open ◽  
2018 ◽  
Vol 8 (7) ◽  
pp. e021531 ◽  
Author(s):  
Bethan Dalton ◽  
Savani Bartholdy ◽  
Jessica McClelland ◽  
Maria Kekic ◽  
Samantha J Rennalls ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Anorexia Nervosa ◽  
Eating Disorder ◽  
Magnetic Stimulation ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Controlled Trial ◽  
Eating Disorder Symptoms ◽  
Randomised Controlled

ObjectiveTreatment options for severe, enduring anorexia nervosa (SE-AN) are limited. Non-invasive neuromodulation is a promising emerging intervention. Our study is a feasibility randomised controlled trial of repetitive transcranial magnetic stimulation (rTMS) in individuals with SE-AN, which aims to inform the design of a future large-scale trial.DesignDouble-blind, parallel group, two-arm, sham-controlled trial.SettingSpecialist eating disorders centre.ParticipantsCommunity-dwelling people with anorexia nervosa, an illness duration of ≥3 years and at least one previous completed treatment.InterventionsParticipants received 20 sessions (administered over 4 weeks) of MRI-guided real or sham high-frequency rTMS to the left dorsolateral prefrontal cortex in addition to treatment-as-usual.OutcomesPrimary outcomes were recruitment, attendance and retention rates. Secondary outcomes included body mass index (BMI), eating disorder symptoms, mood, quality of life and rTMS safety and tolerability. Assessments were conducted at baseline, post-treatment and follow-up (ie, at 0 month, 1 month and 4 months post-randomisation).ResultsThirty-four participants (17 per group) were randomly allocated to real or sham rTMS. One participant per group was withdrawn prior to the intervention due to safety concerns. Two participants (both receiving sham) did not complete the treatment. rTMS was safe and well tolerated. Between-group effect sizes of change scores (baseline to follow-up) were small for BMI (d=0.2, 95% CI −0.49 to 0.90) and eating disorder symptoms (d=0.1, 95% CI −0.60 to 0.79), medium for quality of life and moderate to large (d=0.61 to 1.0) for mood outcomes, all favouring rTMS over sham.ConclusionsThe treatment protocol is feasible and acceptable to participants. Outcomes provide preliminary evidence for the therapeutic potential of rTMS in SE-AN. Largest effects were observed on variables assessing mood. This study supports the need for a larger confirmatory trial to evaluate the effectiveness of multi-session rTMS in SE-AN. Future studies should include a longer follow-up period and an assessment of cost-effectiveness.Trial registration numberISRCTN14329415; Pre-results.

Short-term follow-up of severe bulimia nervosa after inpatient treatment

2003 ◽  
Vol 11 (5) ◽  
pp. 405-417 ◽  
Author(s):  
Øyvind Rø ◽  
Egil W. Martinsen ◽  
Asle Hoffart ◽  
Jan H. Rosenvinge
Keyword(s):  
Bulimia Nervosa ◽  
Inpatient Treatment ◽  
Short Term

scholarly journals Discharge Body Mass Index, Not Illness Chronicity, Predicts 6-Month Weight Outcome in Patients Hospitalized With Anorexia Nervosa

2021 ◽  
Vol 12 ◽  
Author(s):  
Graham W. Redgrave ◽  
Colleen C. Schreyer ◽  
Janelle W. Coughlin ◽  
Laura K. Fischer ◽  
Allisyn Pletch ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Anorexia Nervosa ◽  
Body Mass ◽  
Adult Women ◽  
Short Term ◽  
Illness Duration ◽  
Weight Restoration ◽  
The Impact

Proposed treatments for severe and enduring anorexia nervosa (SE-AN) focus on quality of life, and psychological and social functioning. By de-emphasizing weight restoration as a priority, however, premature diagnosis of SE-AN may reduce potential for recovery. The present study assessed the effect of weight restoration, illness duration, and severity on treatment outcome 6 months after discharge from an intensive, meal-based behavioral treatment program. Participants included hospitalized adult women (N = 191) with AN or underweight other specified feeding and eating disorder (OSFED). Participants were characterized as short-term (ill <7 years; n = 74) or long-term ill (ill ≥ 7 years; n = 117). Compared with short-term ill, long-term ill patients were older, had lower lifetime body mass index (BMI), more prior admissions, and exhibited greater depression and neuroticism. Long-term vs. short-term ill patients gained weight at the same rate (~2 kg/wk) and were equally likely to be weight restored by discharge (>75% reached BMI ≥ 19 kg/m2 in both groups). At 6-month follow-up (n = 99), both groups had equivalent self-reported BMI, and depression, drive for thinness, body dissatisfaction, and bulimia scores. The only predictor of BMI ≥ 19 kg/m2 at follow-up was discharge BMI. The likelihood of a BMI ≥ 19 kg/m2 at follow-up was 5-fold higher for those with discharge BMI ≥ 19 kg/m2. Few studies of long-term ill inpatients with AN have examined the impact of full weight restoration on short-term outcomes. This study supports the therapeutically optimistic stance that, regardless of illness duration, hospitalized patients with AN benefit from gaining weight to a BMI ≥ 19 kg/m2.

Therapy Results and Follow-Up of an Integrated Inpatient Treatment for Severe Cases of Anorexia nervosa

1988 ◽  
Vol 50 (1) ◽  
pp. 5-14 ◽  
Author(s):  
K. Engel ◽  
B. Wilfarth
Keyword(s):  
Anorexia Nervosa ◽  
Inpatient Treatment
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