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Predictive factors of length of inpatient treatment in anorexia nervosa

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Abstract

Objective

To identify clinical variables influencing the length of stay (LOS) of inpatient treatment for anorexia nervosa (AN).

Method

We analyzed structured clinical charts of 300 consecutive hospitalizations for AN in a specialized eating disorder unit. The sample included patients from 12 to 22 years old. Factors related to the patient and events occurring during the stay were investigated as possible predictors of LOS.

Results

Mean LOS was 135 days. The best model of linear regression revealed that the following factors were significantly related to LOS: duration of AN at admission, use of tube feeding during the stay, accomplishment of the therapeutic weight contract and presence of a comorbid disorder.

Conclusions

The identification of factors influencing duration of stay, both at the outset and during the hospitalization, could help clinicians to optimize and individualize treatments, as well as increase patient and family compliance.

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References

  1. Agras WS, Brandt HA, Bulik CM, Dolan-Sewell R, Fairburn CG, Halmi KA, Herzog DB, Jimerson DC, Kaplan AS, Kaye WH, Le Grange D, Lock J, Mitchell JE, Rudorfer MV, Street LL, Striegel-Moore R, Vitousek KM, Walsh BT, Wilfley DE (2004) Report of the national institutes of health workshop on overcoming barriers to treatment research in anorexia nervosa. Int J Eat Disord 35:509–521

    Article  PubMed  Google Scholar 

  2. American Psychiatric Association (2000) Practice guideline for the treatment of patients with eating disorders (revision). Am J Psychiatry 157:1–39

    Google Scholar 

  3. American Psychiatric Association (1994) Diagnostic and statistic manual of mental disorders, 4th edn. American Psychiatric Association, Washington DC

    Google Scholar 

  4. Cachelin FM, Maher BA (1998) Is amenorrhea a critical criterion for anorexia nervosa? J Psychosom Res 44:435–440

    Article  PubMed  CAS  Google Scholar 

  5. Cochran WG (1954) Some methods for strengthening the common chi2. Tests Biometr 10:417–451

    Article  Google Scholar 

  6. Creed F, Mbaya P, Lancashire S, Tomenson B, Williams B, Holme S (1997) Cost effectiveness of day and inpatient psychiatric treatment: results of a randomised controlled trial. Br Med J 314:1381–1385

    CAS  Google Scholar 

  7. Fairburn CG, Harrison PJ (2003) Eating disorders. Lancet 361:407–416

    Article  PubMed  Google Scholar 

  8. Garner DM, Needleman LD (1997) Sequencing and integration of treatments. In: Garner DM, Garfinkel PE (eds)Handbook of treatment of eating disorders, 2nd edn. Guidford Press, New York, pp 50–63

  9. Godart N, Atger F, Perdereau F, Agman G, Rein Z, Corcos M, Jeammet Ph (2004) Treatment of adolescent patients with eating disorders: description of a psychodynamic approach in clinical practice. Eat Weight Disord 9:224–227

    PubMed  CAS  Google Scholar 

  10. Godart N, Perdereau F, Gales O, Agman G, Deborde AS, Jeammet P (2005) The weight contract during the hospitalization of anorexic patients. Arch Pediatr 12:1544–1550

    Article  PubMed  CAS  Google Scholar 

  11. Golden NH, Jacobson MS, Schebendach J, Solanto MV, Hertz SM, Shenker (1997) Resumption of menses in anorexia nervosa. Arch Pediatr Adolesc Med 151:16–21

    PubMed  CAS  Google Scholar 

  12. Goodman R, Simonoff E (1991) Reliability of clinical rating scale by trainee child psychiatrists: a research note. J Child Psychopathol Psychiatry 32:551–555

    Article  CAS  Google Scholar 

  13. Herpertz-Dahlmann BM, Wewetzer C, Schulz E, Remschmidt H (1996) Course and outcome in adolescent anorexia nervosa. Int J Eat Disord 19:335–345

    Article  PubMed  CAS  Google Scholar 

  14. Herzog DB, Keller MB, Lavori PW (1988) Outcome in anorexia nervosa and bulimia nervosa: a review of the literature. J Nerv Ment Dis 176:131–143

    Article  PubMed  CAS  Google Scholar 

  15. Huntley DA, Cho DW, Christman J, Csernansky JG (1998) Predicting length of stay in an acute psychiatric hospital. Psychiatr Serv 49:1049–1053

    PubMed  CAS  Google Scholar 

  16. Institut National d’études démographiques: divorces en France métropolitaine (2003); Available at: http://wwwinedfr/fr/pop_chiffres/france/mariages_nuptialite/divorces/ Accessed September 2006; 15

  17. Jeammet Ph (1984) Contrat et contraintes Dimensions psychologiques de l’hospitalisation dans le traitement de l’anorexique. Psychol Fr 29:137–143

    Google Scholar 

  18. Kahn C, Pike KM (2001) In search of predictors of dropout from inpatient treatment for anorexia nervosa. Int J Eat Disord 30:237–244

    Article  PubMed  CAS  Google Scholar 

  19. Maguire S, Surgenor LJ, Abraham S, Beumont P (2003) An international collaborative database: its use in predicting length of stay for inpatient treatment of anorexia nervosa. Aust N Z J Psychiatry 37:741–747

    Article  PubMed  Google Scholar 

  20. Nozoe S, Soejima Y, Yoshioka M, Naruo T, Masuda A, Nagai N, Tanaka H (1995) Clinical features of patients with anorexia nervosa: assessment of factors influencing the duration of inpatient treatment. J Psychosom Res 39:271–281

    Article  PubMed  CAS  Google Scholar 

  21. Ratnasuriya RH, Eisler Y, Smukler GI, Russel GFM (1991) Anorexia nervosa: outcome and prognosis factors after twenty years. Br J Psychiatry 158:495–502

    Article  PubMed  CAS  Google Scholar 

  22. Robb AS, Silber TJ, Orrell-Valente JK, Valadez-Meltzer A, Ellis N, Dadson MJ, Chatoor I (2002) Supplemental nocturnal nasogastric refeeding for better short-term outcome in hospitalized adolescent girls with anorexia nervosa. Am J Psychiatry 159(8):1347–1353

    Article  PubMed  Google Scholar 

  23. Robinson P (1993) Treatment for eating disorders in the United Kingdom. Part I. A survey on specialist services. Eur Eat Disord Rev 1:4–9

    Article  Google Scholar 

  24. Rolland-Cachera MF, Cole TJ, Sempe M, Tichet J, Rossignol C, Charraud (1991) A body mass index variations: centiles from birth to 87 years. Eur J Clin Nutr 45(1):13–21

    PubMed  CAS  Google Scholar 

  25. Steinhausen HC, Rauss-Mason C, Seidek R (1991) Follow up studies of anorexia nervosa: a review of four decades of outcome research. Psychol Med 81:447–454

    Google Scholar 

  26. Steinhausen HC, Seidel R (1993) Outcome in adolescent eating disorders. Int J Eat Disord 14:487–496

    Article  PubMed  CAS  Google Scholar 

  27. Steinhausen HC (2002) The outcome of anorexia nervosa in the 20th century. Am J Psychiatry 159:1284–1293

    Article  PubMed  Google Scholar 

  28. Strober M, Freeman R, Morrell W (1997) The long-term course of severe anorexia nervosa in adolescents: survival analysis of recovery, relapse and outcome predictors over 10–15 years in a prospective study. Int J Eat Disord 22:339–360

    Article  PubMed  CAS  Google Scholar 

  29. Watson TL, Andersen AE (2003) A critical examination of the amenorrhea and weight criteria diagnosing anorexia nervosa. Acta Psychiatr Scand 108:161–162

    Article  Google Scholar 

  30. Wiseman CV, Sunday RS, Klapper F, Harris WA, Halmi KA (2001) Changing patterns of hospitalisation in eating disorders patients. Int J Eat Disord 30:69–74

    Article  PubMed  CAS  Google Scholar 

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Correspondence to Nathalie Godart MD, PhD.

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Strik Lievers, L., Curt, F., Wallier, J. et al. Predictive factors of length of inpatient treatment in anorexia nervosa. Eur Child Adolesc Psychiatry 18, 75–84 (2009). https://doi.org/10.1007/s00787-008-0706-8

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