Effectiveness of day hospital treatment for anorexia nervosa and bulimia nervosa

2008 ◽  
Vol 16 (5) ◽  
pp. 341-351 ◽  
Author(s):  
Eike Fittig ◽  
Corinna Jacobi ◽  
Herbert Backmund ◽  
Monika Gerlinghoff ◽  
Hans-Ulrich Wittchen
Keyword(s):  
Anorexia Nervosa ◽  
Bulimia Nervosa ◽  
Hospital Treatment ◽  
Day Hospital

scholarly journals Rapid Response to Day Hospital Treatment in Bulimia Nervosa and Purging Disorder: a Randomized Controlled Trial of an Intervention to Facilitate Early Behaviour Change

2021 ◽  
Author(s):  
Danielle Elziabeth MacDonald
Keyword(s):  
Randomized Controlled Trial ◽  
Eating Disorder ◽  
Bulimia Nervosa ◽  
Controlled Trial ◽  
Rapid Response ◽  
Hospital Treatment ◽  
Day Hospital ◽  
Purging Disorder ◽  
Randomized Controlled ◽  
End Of Treatment

Even the most effective treatments for bulimia nervosa and purging disorder have high rates of nonremission and relapse. As such, improving treatment efficacy is an important research priority in this area. Research has consistently demonstrated that rapid response – defined as substantial improvements in key eating disorder behaviours (e.g., binge eating, vomiting, dietary restriction) during the initial weeks of cognitive behavioural therapy (CBT) – is the strongest and most robust predictor of good outcomes at end-of-treatment and in follow-up (Vall & Wade, 2015). Further, research has failed to identify pre-treatment demographic or clinical variables that account for this relationship, suggesting that rapid response is due to elements of CBT itself. This study aimed to demonstrate that rapid response can be clinically facilitated. A four-session CBT intervention focused on encouraging rapid response was compared to a matched-intensity motivational interviewing intervention, both adjunctive to intensive treatment in a randomized controlled trial. The CBT intervention included psychoeducation about rapid response, a focus on goal-setting, and use of behavioural skills for making concrete changes. Forty-four women with bulimia nervosa or purging disorder participated in the study. There were no baseline differences between groups on any demographic or clinical variables. Intent-to-treat results showed that compared to those who received motivational interviewing, participants who received CBT were significantly more likely to make a rapid response to day hospital treatment, and had fewer total eating disorder behaviours and more normalized eating during the first 4 weeks of day hospital treatment. Additionally, between baseline and day hospital end-of-treatment, participants who received CBT made significantly greater improvements on overvaluation of weight and shape and difficulties with emotion regulation. These findings indicate that rapid response to intensive treatment can be clinically facilitated using an adjunctive intervention focused on encouraging rapid and substantial change. These findings also suggest that rapid response may be related to improved outcome via improvements in overvaluation of weight and shape or emotion regulation. This study provides support for theoretical contentions that rapid response is due to CBT-related factors, and provides the framework for future research investigating rapid response as a causal mechanism of good outcome for eating disorders.

scholarly journals Improvements on Clinical Status of Adolescents With Anorexia Nervosa in Inpatient and Day Hospital Treatment: A Retrospective Pilot Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Valeria Zanna ◽  
Giulia Cinelli ◽  
Michela Criscuolo ◽  
Annamaria Caramadre ◽  
Maria Chiara Castiglioni ◽  
...  
Keyword(s):  
Heart Rate ◽  
Anorexia Nervosa ◽  
Pilot Study ◽  
Treatment Program ◽  
Inpatient Treatment ◽  
Inpatient Care ◽  
Clinical Status ◽  
Hospital Costs ◽  
Hospital Treatment ◽  
Day Hospital

Introduction: Medical and psychiatric complications and treatment compliance are important considerations in determining the treatment program for patients with severe anorexia nervosa (AN). Clinical practice guidelines agree that an outpatient program is the first choice for the treatment of most eating disorders, but vary in supporting these programs for AN. However, inpatient care is known to be costly and the risk of relapse and readmission is high. This pilot study aimed to describe the first data on an Italian partial hospitalization care program for AN adolescents [high-level care treatment (HLCT)], evaluating its impact on patients' clinical status, average hospitalization time, and the hospital costs compared to inpatient treatment (IP).Methods: For this retrospective pilot study, we have selected a group of 34 females with AN aged 11–18 years, divided between those who followed inpatient treatment and those who received HLCT treatment; they were matched for age and severity. We investigated the differences in treatment and outcomes between the two groups in terms of heart rate, length of treatment, weight gain, psychological characteristics, and hospital costs. Statistics for non-parametric distributions were used to compare the two groups.Results: No differences between the two groups were found at admission. At discharge, patients in the HLCT group presented a lower number of in-hospital treatment days, a higher increase of weight, and a significant improvement in outcomes compared to the inpatient group. No significant differences were found in heart rate and hospital costs.Conclusions: This study represents a first comparison between inpatient care and the HLCT treatment program, which suggests that day hospital treatment could represent a meeting point between inpatient and outpatient treatment, combining the merits of both forms of treatment. Further studies are needed in order to better investigate the different treatment programs for severe AN in adolescence.

Day Hospital Treatment for Anorexia Nervosa: A 12-Month Follow-up Study

2015 ◽  
Vol 23 (5) ◽  
pp. 390-398 ◽  
Author(s):  
Giovanni Abbate-Daga ◽  
Enrica Marzola ◽  
Carlotta De-Bacco ◽  
Sara Buzzichelli ◽  
Annalisa Brustolin ◽  
...  
Keyword(s):  
Anorexia Nervosa ◽  
Hospital Treatment ◽  
Day Hospital ◽  
Follow Up Study

scholarly journals Corrigendum: Improvements on Clinical Status of Adolescents With Anorexia Nervosa in Inpatient and Day Hospital Treatment: A Retrospective Pilot Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Valeria Zanna ◽  
Giulia Cinelli ◽  
Michela Criscuolo ◽  
Anna Maria Caramadre ◽  
Maria Chiara Castiglioni ◽  
...  
Keyword(s):  
Anorexia Nervosa ◽  
Pilot Study ◽  
Clinical Status ◽  
Hospital Treatment ◽  
Day Hospital
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