Abstract
Objective: There are few follow-up studies on outcome for patients with long standing anorexia nervosa (AN) or non-specified eating disorder with several comorbid psychiatric disorders. Inpatient treatment is one option for these patients. The aim of this prospective study was to report one-year follow-up for a consecutive sample of these patients after an inpatient treatment program. Method: All 24 patients with a mean age of 28 years and mean duration of an eating disorder of 11 years were treated in a 23-week inpatient group treatment program for AN. Patients were assessed using Eating Disorder Examination interview (EDE), Eating Disorder Inventory (EDI) and Symptom Check List (SCL-90-R) at pre-treatment, post-treatment and at one year after start of treatment. At the follow-up 24 patients were personally interviewed. On admission 12 (50%) had AN, 8 (33%) non-specified eating disorder (EDNOS) and 4 (17%) bulimia nervosa (BN). All had previously suffered from AN and were clinically evaluated to have mostly anorectic psychopathology. Results: Ten (42%) patients had improved at follow-up and 14 (58%) had a poor outcome. There was a moderate but significant improvement on the EDE, EDI and GSI from pre-treatment to follow-up. The improvement occurred during inpatient treatment, and no significant differences from post-treatment to follow-up were found. Patients with low weight on admission showed a significant mean weight increase of about 4 kg at the follow-up. Conclusions: At one-year follow-up there was a moderate reduction of eating disorder symptoms and general psychiatric symptoms for patients with long standing anorexic symptoms. The improvement occurred during inpatient treatment. Inpatient treatment may be a treatment option in long-time rehabilitation for some of these patients.
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Ben Tovim D.I., Walker K., Gilchrist P., Freeman R., Kalucy R., Esterman A.: Outcome in patients with eating disorders: a 5-year study. Lancet, 357, 1254–1257, 2001.
Zipfel S., Lowe B., Reas D.L., Deter H.C., Herzog W.: Long-term prognosis in anorexia nervosa: lessons from a 21-year follow-up study. Lancet, 355, 721–722, 2000.
Steinhausen H.C., Seidel R., Winkler M.C.: Evaluation of treatment and intermediate and long-term outcome of adolescent eating disorders. Psychol. Med., 30, 1089–1098, 2000.
Fichter M.M., Quadflieg N.: Six-year course and outcome of anorexia nervosa. Int. J. Eat. Disord., 26, 359–385, 1999.
Strober M., Freeman R., Morrell W.: The long-term course of anorexia nervosa in adolescents. Int. J. Eat. Disord., 22, 339–360, 1997.
Steinhausen H.C.: The outcome of anorexia nervosa in the 20th century. Am. J. Psychiatry, 159, 1284–1293, 2002.
Herzog W., Schellberg D., Deter H.C.: First recovery in anorexia nervosa in the long-term course: a discretetime survival analysis. J. Consult. Clin. Psychol., 65, 169–177, 1997.
Nielsen S.: Epidemiology and mortality of eating disorders. Psychiatr. Clin. North Am., 24, 201–214, 2001.
Sullivan P.F.: Mortality in anorexia nervosa. Am. J. Psychiatry, 152, 1073–1074, 1995.
Russell G.F., Szmukler G.I., Dare C., Eisler I.: An evaluation of family therapy in anorexia nervosa and bulimia nervosa. Arch. Gen. Psychiatry, 44, 1047–1056, 1987.
Robin A.L., Siegel P.T., Moye A.W., Gilroy M., Dennis A.B., Sikand A.: A controlled comparison of family versus individual therapy for adolescents with anorexia nervosa. J. Am. Acad. Child Adolesc. Psychiatry, 38, 1482–89, 1999.
Eisler I., Dare C., Russell G.F., Szmukler G., Le Grange D., Dodge E.: Family and individual therapy in anorexia nervosa. A 5-year follow-up. Arch. Gen. Psychiatry, 54, 1025–1030, 1997.
Eisler I., Dare C., Hodes M., Russell G., Dodge E., Le Grange D.: Family therapy for adolescent anorexia nervosa: the results of a controlled comparison of two family interventions. J. Child Psychol. Psychiatry, 41, 727–736, 2000.
Fairburn C.G., Norman P.A., Welch S.L., O’Connor M.E., Doll H.A., Peveler R.C.: A prospective study of outcome in bulimia nervosa and the long-term effects of three psychological treatments. Arch. Gen. Psychiatry, 52, 304–312, 1995.
Dare C., Eisler I., Russell G., Treasure J., Dodge L.: Psychological therapies for adults with anorexia nervosa: randomised controlled trial of out-patient treatments. Br. J. Psychiatry, 178, 216–221, 2001.
Engel K.: Termination of inpatient treatment of anorexia nervosa. Psychother. Psychosom., 51, 62–68, 1989.
Gowers S.G., Weetman J., Shore A., Hossain F., Elvins R.: Impact of hospitalisation on the outcome of adolescent anorexia nervosa. Br. J. Psychiatry, 176, 138–141, 2000.
Meads C., Gold L., Burls A.: How effective is outpatient care compared to inpatient care for the treatment of anorexia nervosa? A systematic review. Eur. Eat. Disord. Rev., 9, 229–241, 2001.
American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, 4th ed. Draft (DSM-IV), Washington, DC, APA Press, 1993
Fairburn C.G., Cooper Z.: The eating disorder examination. In: Fairburn C.G., Wilson G.T. (Eds.), Binge eating: Nature, Assessment and Treatment. 12th ed., London, Guildford, 1993, pp. 317–360.
Derogatis L.R., Lipman R.S., Covi L.: SCL-90: an outpatient psychiatric rating scale-preliminary report. Psychopharmacol. Bull. 9, 13–28, 1973.
Garner D.M., Olmstedt M.P., Polivy J.: Development and validation of a multidimensional eating disorder inventory for anorexia and bulimia. Int. J. Eat. Disord., 2, 15–34, 1993.
Spitzer R.L., Williams J.B., Gibbon M.: Structured clinical interview for the DSM-IV Axis II. New York, New York State Psychiatric Institute, Biometrics Research Department, 1995.
Nevonen L., Broberg A.G.: Validating the Eating Disorder Inventory-2 (EDI-2) in Sweden. Eat. Weight Disord., 6, 59–67, 2001.
Cohen J.: Statistical power analysis for the behavioral sciences, 2nd ed., Hillsdale, New York, Academic Press, 1988.
Andersen A.E., Bowers W., Evans K.: Inpatient treatment of anorexia nervosa. In Garner D.M., Garfinkel P.E. (Eds.), Handbook of Treatment for Eating Disorder. 2nd ed., New York, Guildford, 1997, pp. 327–348.
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Rø, Ø., Martinsen, E.W., Hoffart, A. et al. Short-term follow-up of adults with long standing anorexia nervosa or non-specified eating disorder after inpatient treatment. Eat Weight Disord 9, 62–68 (2004). https://doi.org/10.1007/BF03325047
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DOI: https://doi.org/10.1007/BF03325047