scholarly journals 08 - Milieu therapy in in-patient treatment for adolescents with anorexia nervosa

2019 ◽  
Author(s):  
Thibaut Lebailly ◽  
Saint-André Stéphane
Keyword(s):  
Anorexia Nervosa ◽  
Patient Treatment ◽  
Milieu Therapy

Clinical features of patients with anorexia nervosa: Assessment of factors influencing the duration of in-patient treatment

1995 ◽  
Vol 39 (3) ◽  
pp. 271-281 ◽  
Author(s):  
Shin-Ichi Nozoe ◽  
Yuji Soejima ◽  
Mitsuki Yoshioka ◽  
Tetsurou Naruo ◽  
Akinori Masuda ◽  
...  
Keyword(s):  
Anorexia Nervosa ◽  
Clinical Features ◽  
Patient Treatment ◽  
Factors Influencing

scholarly journals Excess mortality, causes of death and prognostic factors in anorexia nervosa

2009 ◽  
Vol 194 (1) ◽  
pp. 10-17 ◽  
Author(s):  
Fotios C. Papadopoulos ◽  
Anders Ekbom ◽  
Lena Brandt ◽  
Lisa Ekselius
Keyword(s):  
Anorexia Nervosa ◽  
Prognostic Factors ◽  
Causes Of Death ◽  
Patient Treatment ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Somatic Comorbidity ◽  
Assessment And Treatment ◽  
Mortality Causes ◽  
Almost All

BackgroundAnorexia nervosa is a mental disorder with high mortality.AimsTo estimate standardised mortality ratios (SMRs) and to investigate potential prognostic factors.MethodSix thousand and nine women who had in-patient treatment for anorexia nervosa were followed-up retrospectively using Swedish registers.ResultsThe overall SMR for anorexia nervosa was 6.2 (95% CI 5.5– 7.0). Anorexia nervosa, psychoactive substance use and suicide had the highest SMR. The SMR was significantly increased for almost all natural and unnatural causes of death. The SMR 20 years or more after the first hospitalisation remained significantly high. Lower mortality was found during the last two decades. Younger age and longer hospital stay at first hospitalisation was associated with better outcome, and psychiatric and somatic comorbidity worsened the outcome.ConclusionsAnorexia nervosa is characterised by high lifetime mortality from both natural and unnatural causes. Assessment and treatment of psychiatric comorbidity, especially alcohol misuse, may be a pathway to better long-term outcome.

scholarly journals Clinical effectiveness of treatments for anorexia nervosa in adolescents

2007 ◽  
Vol 191 (5) ◽  
pp. 427-435 ◽  
Author(s):  
Simon G. Gowers ◽  
Andrew Clark ◽  
Chris Roberts ◽  
Alison Griffiths ◽  
Vanessa Edwards ◽  
...  
Keyword(s):  
Anorexia Nervosa ◽  
Health Service ◽  
Treatment Guidelines ◽  
Psychiatric Treatment ◽  
Controlled Trial ◽  
Clinical Effectiveness ◽  
Patient Treatment ◽  
Intention To Treat ◽  
Poor Outcomes ◽  
Randomised Controlled

BackgroundTreatment guidelines identify few adequately powered trials to guide recommendations for anorexia nervosa.AimsTo evaluate the effectiveness of three readily available National Health Service treatments for adolescents (aged 12–18 years) with anorexia nervosa.MethodMulticentre randomised controlled trial of 167 young people comparing in-patient, specialist out-patient and general child and adolescent mental health service (CAMHS) treatment.ResultsEach group made considerable progress at 1 year, with further improvement by 2 years. Full recovery rates were poor (33% at 2 years, 27% still with anorexia nervosa). Adherence to in-patient treatment was only 50%. Neither in-patient nor specialist out-patient therapy demonstrated advantages over general CAMHS treatment by intention to treat, although some CAMHS out-patients were subsequently admitted on clinical grounds. In-patient treatment (randomised or after out-patient transfer) predicted poor outcomes.ConclusionsFirst-line in-patient psychiatric treatment does not provide advantages over out-patient management. Out-patient treatment failures do very poorly on transfer to in-patient facilities.

Down's Syndrome and Eating Disorders

1988 ◽  
Vol 152 (6) ◽  
pp. 847-848 ◽  
Author(s):  
G. M. Holt ◽  
N. Bouras ◽  
J. P. Watson
Keyword(s):  
Eating Disorders ◽  
Anorexia Nervosa ◽  
Clinical Symptoms ◽  
Down's Syndrome ◽  
Down’S Syndrome ◽  
Patient Treatment

We describe the case of a 33-year-old man with Down's syndrome and severe eating disorders. The clinical symptoms, and their difference from those of anorexia nervosa, are discussed. The patient responded well to a strict behavioural programme after long, in-patient treatment and was still well at a 2-year follow-up examination.

scholarly journals A randomised controlled trial of in-patient treatment for anorexia nervosa in medically unstable adolescents

2015 ◽  
Vol 3 (S1) ◽  
Author(s):  
Sloane Madden ◽  
Jane Miskovic-Wheatley ◽  
Andrew Wallis ◽  
Michael Kohn ◽  
James Lock ◽  
...  
Keyword(s):  
Anorexia Nervosa ◽  
Randomised Controlled Trial ◽  
Controlled Trial ◽  
Patient Treatment ◽  
Randomised Controlled

scholarly journals Psychological therapies for adults with anorexia nervosa

2001 ◽  
Vol 178 (3) ◽  
pp. 216-221 ◽  
Author(s):  
Chris Dare ◽  
Ivan Eisler ◽  
Gerald Russell ◽  
Janet Treasure ◽  
Liz Dodge
Keyword(s):  
Anorexia Nervosa ◽  
Family Therapy ◽  
Symptomatic Improvement ◽  
Adult Patients ◽  
Psychoanalytic Psychotherapy ◽  
Control Treatment ◽  
Patient Treatment ◽  
Psychological Therapies ◽  
Analytic Therapy

BackgroundCurrently, without systematic evidence, psychotherapy for anorexia nervosa in adults draws on psychodynamic, cognitive and systemic theories.AimsTo assess effectiveness of specific psychotherapies in out-patient management of adult patients with anorexia nervosa.MethodEighty-four patients were randomised to four treatments: three specific psychotherapies – (a) a year of focal psychoanalytic psychotherapy; (b) 7 months of cognitive-analytic therapy (CAT); (c) family therapy for 1 year – and (d) low contact, ‘routine’ treatment for 1 year (control).ResultsAt 1 year, there was symptomatic improvement in the whole group of patients. This improvement was modest, several patients being significantly undernourished at follow-up. Psychoanalytic psychotherapy and family therapy were significantly superior to the control treatment; CAT tended to show benefits.ConclusionsPsychoanalytic and family therapy are of specific value in the out-patient treatment of adult patients with anorexia.

scholarly journals Cost-effectiveness of focal psychodynamic therapy and enhanced cognitive–behavioural therapy in out-patients with anorexia nervosa

2016 ◽  
Vol 46 (16) ◽  
pp. 3291-3301 ◽  
Author(s):  
N. Egger ◽  
B. Wild ◽  
S. Zipfel ◽  
F. Junne ◽  
A. Konnopka ◽  
...  
Keyword(s):  
Anorexia Nervosa ◽  
Cost Effectiveness ◽  
Cognitive Behavioural Therapy ◽  
Cost Effective ◽  
Behavioural Therapy ◽  
Patient Treatment ◽  
Base Case ◽  
Adult Women ◽  
Net Benefit ◽  
Cognitive Behavioural

BackgroundAnorexia nervosa (AN) is a serious illness leading to substantial morbidity and mortality. The treatment of AN very often is protracted; repeated hospitalizations and lost productivity generate substantial economic costs in the health care system. Therefore, this study aimed to determine the differential cost-effectiveness of out-patient focal psychodynamic psychotherapy (FPT), enhanced cognitive–behavioural therapy (CBT-E), and optimized treatment as usual (TAU-O) in the treatment of adult women with AN.MethodThe analysis was conducted alongside the randomized controlled Anorexia Nervosa Treatment of OutPatients (ANTOP) study. Cost-effectiveness was determined using direct costs per recovery at 22 months post-randomization (n = 156). Unadjusted incremental cost-effectiveness ratios (ICERs) were calculated. To derive cost-effectiveness acceptability curves (CEACs) adjusted net-benefit regressions were applied assuming different values for the maximum willingness to pay (WTP) per additional recovery. Cost–utility and assumptions underlying the base case were investigated in exploratory analyses.ResultsCosts of in-patient treatment and the percentage of patients who required in-patient treatment were considerably lower in both intervention groups. The unadjusted ICERs indicated FPT and CBT-E to be dominant compared with TAU-O. Moreover, FPT was dominant compared with CBT-E. CEACs showed that the probability for cost-effectiveness of FTP compared with TAU-O and CBT-E was ⩾95% if the WTP per recovery was ⩾€9825 and ⩾€24 550, respectively. Comparing CBT-E with TAU-O, the probability of being cost-effective remained <90% for all WTPs. The exploratory analyses showed similar but less pronounced trends.ConclusionsDepending on the WTP, FPT proved cost-effective in the treatment of adult AN.

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