Predictors of dropout from inpatient treatment for eating disorders

IntroductionDrop-out from treatment for Eating Disorders is increasing (Campbell; 2007), and it is a risk factor for relapse and more chronic and severe course of the illness (Fassino et al.; 2009). Drop-out can be caused by interaction of concurrent, individual, familiar ad environmental factors (Sly; 2009).Aim of the studyTo examine possible risk factors of drop-out from inpatient treatment for eating disorders.Materials and methodsThe sample included 41 patients who voluntarily left the treatment before completion (’droppers’) and 88 patients who completed it (’completers’), in the period between 1st January 2006 and 31st December 2009 at Villa Maria Luigia Hospital (Monticelli Terme, PR, Italy). Patients were administered 2 self-report questionnaires and 3 psychometric tests: Eating Disorders Questionnaire, Predisposing, bringing on and maintaining risk factors for eating disorders, EDI-II, BUT, SCL-90.ResultsDroppers appear to be more aggressive (p = 0.022), get worse scholastic results (p = 0.016) and have less friendships and less social interaction (p = 0.021). Parental break-up (p = 0.015), moving house (p = 0.006), father's death (p = 0.005), abortition (p = 0.040), father's alcohol abuse (p = 0.011) and a mother who suffers of eating disorder (p = 0.008) are more frequent in droppers than completers. Catholic religion seems to be a protective factor from drop-out (p = 0.005).ConclusionDrop-out is a multifactor phenomenon; identification of risk factors can improve treatment strategies and outcome.

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Why Do People With Eating Disorders Drop Out From Inpatient Treatment?

The Journal of Nervous and Mental Disease ◽

10.1097/nmd.0b013e318266bbba ◽

2012 ◽

Vol 200 (9) ◽

pp. 807-813 ◽

Cited By ~ 19

Author(s):

Alexandra Pham-Scottez ◽

Caroline Huas ◽

Fernando Perez-Diaz ◽

Clémentine Nordon ◽

Snezana Divac ◽

...

Keyword(s):

Eating Disorders ◽

Inpatient Treatment ◽

Drop Out

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Undue influence of weight and shape: is it distinct from body dissatisfaction and concern about weight and shape?

Psychological Medicine ◽

10.1017/s0033291710001066 ◽

2010 ◽

Vol 41 (4) ◽

pp. 819-828 ◽

Cited By ~ 19

Author(s):

T. D. Wade ◽

G. Zhu ◽

N. G. Martin

Keyword(s):

Risk Factors ◽

Eating Disorders ◽

Body Dissatisfaction ◽

Environmental Risk ◽

Self Esteem ◽

Structured Interview ◽

Environmental Risk Factors ◽

Self Report ◽

Undue Influence ◽

Diagnostic Criterion

BackgroundThree cognitive constructs are risk factors for eating disorders: undue influence of weight and shape, concern about weight and shape, and body dissatisfaction (BD). Undue influence, a diagnostic criterion for eating disorders, is postulated to be closely associated with self-esteem whereas BD is postulated to be closely associated with body mass index (BMI). We understand less about the relationships with concern about weight and shape. The aim of the current investigation was examine the degree of overlap across these five phenotypes in terms of latent genetic and environmental risk factors in order to draw some conclusions about the similarities and differences across the three cognitive variables.MethodA sample of female Australian twins (n=1056, including 348 complete pairs), mean age 35 years (s.d.=2.11, range 28–40), completed a semi-structured interview about eating pathology and self-report questionnaires. An independent pathways model was used to investigate the overlap of genetic and environmental risk factors for the five phenotypes.ResultsIn terms of variance that was not shared with other phenotypes, self-esteem emerged as being separate, with 100% of its variance unshared with the other phenotypes, followed by undue influence (51%) and then concern (34%), BD (28%) and BMI (32%).ConclusionsIn terms of shared genetic risk, undue influence and concern were more closely related than BD, whereas BMI and BD were found to share common sources of risk. With respect to environmental risk factors, concern, BMI and BD were more closely related to each other than to undue influence.

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Social anxiety in the eating disorders: a systematic review and meta-analysis

Psychological Medicine ◽

10.1017/s0033291718000752 ◽

2018 ◽

Vol 48 (15) ◽

pp. 2477-2491 ◽

Cited By ~ 20

Author(s):

Jess Kerr-Gaffney ◽

Amy Harrison ◽

Kate Tchanturia

Keyword(s):

Eating Disorders ◽

Social Anxiety ◽

Meta Analysis ◽

Treatment Strategies ◽

Self Report ◽

Effect Sizes ◽

Healthy Controls ◽

Comorbid Conditions ◽

Current Review ◽

Meta Analyses

AbstractSocial anxiety disorder is one of the most common comorbid conditions in eating disorders (EDs). The aim of the current review and meta-analysis is to provide a qualitative summary of what is known about social anxiety (SA) in EDs, as well as to compare levels of SA in those with EDs and healthy controls. Electronic databases were systematically searched for studies using self-report measures of SA in ED populations. In total, 38 studies were identified, 12 of which were included in the meta-analyses. For both anorexia nervosa (AN) and bulimia nervosa, there were significant differences between ED groups and HCs, with medium to large effect sizes. Findings from the qualitative review indicate that levels of SA are similar across the ED diagnoses, and SA improves with treatment in AN. In addition, high levels of SA are associated with more severe ED psychopathology, but not body mass index. These findings add to the wider literature on socio-emotional functioning in EDs, and may have implications for treatment strategies.

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Sex differences in psychiatric inpatients: Demographics, psychiatric diagnoses and medical comorbidities

European Psychiatry ◽

10.1016/j.eurpsy.2017.01.1231 ◽

2017 ◽

Vol 41 (S1) ◽

pp. S698-S698

Author(s):

P. Oliveira ◽

M. Coroa ◽

N. Madeira ◽

V. Santos

Keyword(s):

Risk Factors ◽

Sex Differences ◽

Protective Factor ◽

Psychiatric Patients ◽

Treatment Strategies ◽

Psychiatric Inpatients ◽

Psychiatric Diagnoses ◽

Medical Comorbidities ◽

Co Morbidity ◽

Competing Interest

ObjectivesThere are few published studies on the relationship between gender and psychiatric disorders. We assessed sex differences in a sample of first-admission psychiatric inpatients to identify possible risk factors and targets for sex-tailored treatment interventions.MethodsA retrospective study of admissions to the psychiatry department, Coimbra hospital Universitary Centre, Portugal, in 2015 was accomplished (n = 924). The two groups were compared for demographic features, psychiatric diagnoses and medical comorbidities.ResultsMale patients were significantly younger (age average = 47.7 vs. 53.3). Differences in employment, educational, and marital statuses were found between male and female psychiatric patients. Having a degree was a protective factor for males, whereas it was a risk factor for females. Being divorced and single were both risk factors for medical co-morbidity in females. A higher proportion of men among patients hospitalized for schizophrenia (14.9 vs. 5.5%) or substance use disorder (10.3 vs. 2.1%) and a higher proportion of women among those admitted for affective disorders (43.3 vs. 25.9%), including bipolar disorder (13.4 vs. 9.0%), were found. No significant differences in duration of hospitalization between the two groups (22.8 in male vs. 22.2 days in female)ConclusionsThe differences between the two groups of inpatients were very pronounced. A better understanding of these differences may help to establish more effective treatment strategies.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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The Construction of Risk and Protective Factor Indices for Adolescent Alcohol and other Drug Use

Journal of Drug Issues ◽

10.1177/002204269502500412 ◽

1995 ◽

Vol 25 (4) ◽

pp. 837-863 ◽

Cited By ~ 34

Author(s):

David J. DeWit ◽

Gloria Silverman ◽

Michael Goodstadt ◽

Gina Stoduto

Keyword(s):

Risk Factors ◽

High Risk ◽

Drug Use ◽

Problem Behaviors ◽

Protective Factor ◽

Self Report ◽

Regression Equations ◽

Protective Measures ◽

Illegal Drug Use ◽

Main Effects

This paper applies the risk factor approach to assess the influence of protection and risk on five measures of substance use: overall involvement in drugs, frequent alcohol use, frequent illegal drug use, frequent drug abuse, and quantity of daily cigarette consumption. For each measure, it was hypothesized that an index of risk factors would serve to increase the likelihood of the occurrence of problem behavior and that an index of protection would result in a reduction. It was also hypothesized that under conditions of high risk the effect of protection would moderate the influence of risk factors more forcefully than under conditions of low risk. Data were obtained from a self-report questionnaire containing over 60 risk and protective measures administered to nearly 400 grade 9 students in 7 high schools located in Toronto, Canada. Measures were tested in a series of regression equations to construct indices of risk and protective factors for each substance measure. Results supported the hypothesis of separate risk and protective factor main effects for all categories of substances. Evidence of moderate to strong interaction effects (i.e., a moderating influence of protection) were also noted. Implications are discussed for methods of identifying high risk youth as well as programs designed to prevent/reduce problem behaviors among this group.

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Gratitude, Forgiveness, and Anger: Resources and Risk Factors for Italian Prison Inmates

International Journal of Offender Therapy and Comparative Criminology ◽

10.1177/0306624x211049191 ◽

2021 ◽

pp. 0306624X2110491

Author(s):

Francesca Danioni ◽

Francesca Giorgia Paleari ◽

Sara Pelucchi ◽

Maria Rita Lombrano ◽

Daniel Lumera ◽

...

Keyword(s):

Risk Factors ◽

Protective Factor ◽

Northern Italy ◽

Self Report ◽

Psychological Wellbeing ◽

Prison Inmates ◽

Social Concern ◽

Interpersonal Forgiveness ◽

Violent Behaviors

The adjustment of prison inmates is recently becoming a social concern. In the current study we focused on the role of gratitude, interpersonal forgiveness, and anger, which have been widely addressed as likely to influence people’s health and adaptive behaviors, in shaping prison inmates’ psychological wellbeing and criminal attitudes. Participants were 104 male prison inmates aged between 24 and 75 ( Mage = 46.63, SD = 11.38) imprisoned in Northern Italy who were asked to fill in an anonymous self-report questionnaire. Results highlighted that all dimensions considered play an important, albeit different and highly specific, role; Gratitude is a promotional factor that enhances psychological wellbeing, whereas interpersonal forgiveness appears to be a protective factor against the adoption of a criminal attitude as violence or antisocial intent. Finally, anger is a risk factor toward both psychological wellbeing and violent behaviors. Implications of these results and further developments of the study are discussed.

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Risk factors for Clostridium difficile infection and colonization among patients admitted to intensive care units in Shanghai, China

10.21203/rs.2.13271/v1 ◽

2019 ◽

Author(s):

Yingchao Cui ◽

Lihua Zhang ◽

Danfeng Dong ◽

Daosheng Wang ◽

Cen Jiang ◽

...

Keyword(s):

Risk Factors ◽

Intensive Care ◽

Clostridium Difficile ◽

Intensive Care Units ◽

Clostridium Difficile Infection ◽

Protective Factor ◽

Treatment Strategies ◽

Hospital Stays ◽

A Prospective Study ◽

Epidemiological Characteristics

Abstract Background : Clostridium difficile is considered to be the main pathogen responsible for hospital-acquired infections in western countries, but few studies on C. difficile have been carried out in China. This study performed a prospective study to describe the prevalence, molecular epidemiological characteristics and risk factors of Clostridium difficile infection (CDI) and Clostridium difficile colonization (CDC) among patients in intensive care units (ICUs), with the aim of providing strategies for efficient CD prevention and control.Methods: Stool samples were collected from adult patients on admission to an 18-bed ICU department, and were anaerobically cultured for C. difficile . The identified isolates were tested for toxin genes, followed by multilocus sequence typing to analyze the genotypes. Patients were divided into CDI, CDC and control groups according to clinical features. The medical records of these groups were collected and further analyzed using logistic regression to investigate the risk factors.Results: Of the 800 patients included in the study, 33 (4.12%) and 25 (3.12%) patients were identified with CDI and CDC, respectively. An association was found between CDI patients and having a fever (OR=13.993) or metabolic disorder (OR=7.972), and treatment with fluoroquinolone (OR=42.696) or a combination of antibiotics (OR=2.856). CDC patients were characterized by longer hospital stays (OR=1.137), an increased number of comorbidities (OR=36.509), respiratory diseases (OR=0.043) and treatment with vancomycin (OR=18.168). However, treatment with metronidazole was simultaneously found to be a protective factor in the two groups (OR=0.042; OR=0.013). Eighteen sequence types (STs) were identified. Among the CDI group, the isolates were predominantly toxin A- and toxin B-positive (A+B+) strains and genotype ST-2 was the epidemic clone. In the CDC group, the dominant strains were A+B+ and ST-81 was the epidemic clone.Conclusions: The prevalence of C. difficile colonization and infection in our ICU patients was relatively high, suggesting the importance of routine screening to detect the acquisition of this pathogen. Future prevention and treatment strategies for C. difficile -related disease should take into consideration the duration of hospital stays, enteral nutrition, underlying comorbidities, as well as the use of combined antibiotics. Moreover, metronidazole could be a protective factor for both CDI and CDC.

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