Therapy Results and Follow-Up of an Integrated Inpatient Treatment for Severe Cases of Anorexia nervosa

1988 ◽  
Vol 50 (1) ◽  
pp. 5-14 ◽  
Author(s):  
K. Engel ◽  
B. Wilfarth
Keyword(s):  
Anorexia Nervosa ◽  
Inpatient Treatment

Outcome of severe anorexia nervosa patients receiving inpatient treatment in Japan: An 8-year follow-up study

2001 ◽  
Vol 55 (4) ◽  
pp. 389-396 ◽  
Author(s):  
Hideki Tanaka ◽  
Nobuo Kiriike ◽  
Toshihiko Nagata ◽  
Keisen Riku
Keyword(s):  
Anorexia Nervosa ◽  
Inpatient Treatment ◽  
Follow Up Study

scholarly journals Motivation to Change in the Course of a Pilot Study of a Step-Down Treatment Approach of Inpatient and Anorexia Nervosa-Specific Home Treatment and Its Effects on Treatment Outcome

2021 ◽  
Vol 12 ◽  
Author(s):  
Kathrin Sophie Heider ◽  
Astrid Dempfle ◽  
Sophie Altdorf ◽  
Beate Herpertz-Dahlmann ◽  
Brigitte Dahmen
Keyword(s):  
Anorexia Nervosa ◽  
Treatment Outcome ◽  
Inpatient Treatment ◽  
Treatment Approach ◽  
Illness Severity ◽  
Home Treatment ◽  
Motivation To Change ◽  
Sum Score ◽  
Step Down

Introduction: Anorexia nervosa (AN) is a serious mental disorder that typically manifests in adolescence. Motivation to change is an important predictor for treatment outcome in adolescent AN, even though its development over the often long therapeutic process, with transitions between treatment settings, has not yet been studied. In this pilot study, the course of motivation to change and its effect on treatment outcome were investigated over the course of a step-down treatment approach during a 12-month observation period.Methods: Twenty-one adolescents admitted to inpatient treatment because of AN received multidisciplinary home treatment (HoT) with several weekly visits after short inpatient stabilization. Eating disorder (ED-)specific cognitive [Eating Disorder Inventory 2 (EDI-2) subscales] and physical [% expected body weight (%EBW)] illness severity and motivation to change [Anorexia Nervosa Stages of Change Questionnaire (ANSOCQ)] were assessed at the time of admission, discharge from hospital, at the end of HoT, and at a 12-month follow-up. Changes in motivation over time and its relationship with treatment outcome were investigated.Results: Mean motivation to change improved significantly over the course of treatment from the contemplation stage [2nd stage, mean ANSOCQ sum score 47.26 (SD 17.60)] at admission to the action stage [4th stage, mean ANSOCQ sum score 77.64 (SD 18.97)] at the end of HoT (p < 0.001) and remained stable during the follow-up period. At each assessment, higher motivation to change was significantly correlated with lower ED-specific cognitive illness severity (Spearman ρs: −0.53 to −0.77, all p < 0.05). Only pretreatment motivation to change significantly predicted ED-specific cognitive illness severity after the first inpatient treatment phase when taking prior illness severity into account.Conclusions: Motivation to change is an important aspect of treatment success in adolescent AN, especially in the early phase of treatment. In addition, home treatment contributed significantly to a higher motivation. Further longitudinal research into how motivation to change in adolescent patients with AN is related to outcome in this often severe and enduring disease and into targeted therapeutic strategies and interventions that reliably enhance the motivation to change in adolescent patients with AN seems promising.

scholarly journals Assessment of Physical Activity Patterns in Adolescent Patients with Anorexia Nervosa and Their Effect on Weight Gain

2020 ◽  
Vol 9 (3) ◽  
pp. 727 ◽  
Author(s):  
Miriam Kemmer ◽  
Christoph U. Correll ◽  
Tobias Hofmann ◽  
Andreas Stengel ◽  
Julia Grosser ◽  
...  
Keyword(s):  
Physical Activity ◽  
Anorexia Nervosa ◽  
Weight Gain ◽  
Inpatient Treatment ◽  
Activity Patterns ◽  
Healthy Controls ◽  
Metabolic Equivalent ◽  
High Level ◽  
Over Time

(1) Background: Altered physical activity (PA) affects weight recovery in anorexia nervosa (AN) patients. The study aimed to objectively characterize PA patterns and their effect on weight trajectory in adolescent AN patients. (2) Methods: PA was assessed in 47 patients on admission to inpatient treatment, in n = 25 of these patients again 4 weeks after discharge (follow-up, FU), as well as in 20 adolescent healthy controls using the Sense Wear™ armband. The following PA categories were defined by metabolic equivalent (MET) ranges: sedentary behavior (SB), light (LPA), moderate (MPA), vigorous (VPA), and high-level PA (HLPA= MPA + VPA). (3) Results: LPA on admission was significantly higher in AN patients than in controls (103 vs. 55 min/d, p < 0.001), and LPA in AN decreased over time to 90 min/d (p = 0.006). Patients with higher admission LPA (n = 12) still had elevated LPA at FU (p = 0.003). High admission LPA was associated with a higher inpatient BMI percentage gain (ΔBMI%; 18.2% ± 10.0% vs. 12.0% ± 9.7%, p = 0.037) but with a loss of ΔBMI% at FU (−2.3% ± 3.6% vs. 0.8% ± 3.6%, p = 0.045). HLPA at baseline was associated with a lower inpatient ΔBMI% (p = 0.045). (4) Conclusion: Elevated LPA in AN patients decreased after inpatient treatment, and PA patterns had an impact on weight trajectory.

scholarly journals Predictors of illness course and health maintenance following inpatient treatment among patients with anorexia nervosa

2020 ◽  
Vol 8 (1) ◽  
Author(s):  
Deborah R. Glasofer ◽  
Alexandra F. Muratore ◽  
Evelyn Attia ◽  
Peng Wu ◽  
Yuanjia Wang ◽  
...  
Keyword(s):  
Anorexia Nervosa ◽  
Eating Disorder ◽  
Inpatient Treatment ◽  
Weight Status ◽  
Self Report ◽  
Healthy Weight ◽  
Health Maintenance ◽  
Duration Of Illness ◽  
Clinical Impairment

Abstract Background Anorexia nervosa (AN) is a life-threatening psychiatric disorder associated with significant medical and psychosocial impairment. Hospital-based behavioral treatment is an effective intervention in the short-term. However, relapse rates following discharge are high and thus, there is a need to identify predictors of longitudinal outcome. The current study provides information regarding illness course and health maintenance among patients with AN over 5 years following discharge from an eating disorder inpatient unit. Methods Participants were individuals with AN who were discharged from a specialized, inpatient behaviorally-based unit. Prior to discharge, height and weight were measured and participants completed self-report measures of eating disorder severity and general psychopathology (depression, anxiety, harm avoidance). Participants were contacted annually for self-report measures of weight, eating disorder severity and clinical impairment. Outcome was defined by illness course (body mass index (BMI) and clinical impairment during the 5 years) and health maintenance (categories of weight and eating disorder symptom severity) across follow-up, using all available data. Linear mixed models were used to examine whether demographic and clinical parameters at discharge predicted BMI and clinical impairment over time. Additional analyses examined whether these variables significantly influenced an individual’s likelihood of maintaining inpatient treatment gains. Results One-hundred and sixty-eight individuals contributed data. Higher trait anxiety at discharge was associated with a lower BMI during follow-up (p = 0.012). There was a significant interaction between duration of illness and time, whereby duration of illness was associated with a faster rate of weight loss (p = 0.003) during follow-up. As duration of illness increased, there was a greater increase in self-reported clinical impairment (p = 0.011). Increased eating disorder severity at discharge was also associated with greater clinical impairment at follow-up (p = 0.004). Higher BMI at discharge was significantly associated with maintaining healthy weight across a priori BMI-based definitions of health maintenance. Conclusions Weight status (higher BMI) and duration of illness are key factors in the prognosis of AN. Higher weight targets in intensive treatments may be of value in improving outcomes.

scholarly journals Inpatient treatment of anorexia nervosa in adolescents: A 1‐year follow‐up study

2020 ◽  
Author(s):  
Adrian Meule ◽  
Dominic Schrambke ◽  
Artur Furst Loredo ◽  
Sandra Schlegl ◽  
Silke Naab ◽  
...  
Keyword(s):  
Anorexia Nervosa ◽  
Inpatient Treatment ◽  
Follow Up Study

scholarly journals Cognitive Function in Adults with Enduring Anorexia Nervosa

Nutrients ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 859
Author(s):  
Maria Seidel ◽  
Helen Brooker ◽  
Kamilla Lauenborg ◽  
Keith Wesnes ◽  
Magnus Sjögren
Keyword(s):  
Anorexia Nervosa ◽  
Cognitive Function ◽  
Episodic Memory ◽  
Reaction Times ◽  
Assessment System ◽  
Cognitive Test ◽  
Attention Tasks ◽  
Inclusion Study ◽  
Prospective Longitudinal

Anorexia Nervosa (AN) is a severe and often enduring disorder characterized by restriction of food intake, low body weight, fear of weight gain, and distorted body image. Investigations on cognition performance in AN patients have yielded conflicting results. Using an established and sensitive computerized cognitive test battery, we aimed to assess core aspects of cognitive function, including attention span, information processing, reasoning, working and episodic memory, in AN patients and controls. Patients were recruited from the Danish Prospective Longitudinal all-comer inclusion study in Eating Disorders (PROLED). Included were 26 individuals with AN and 36 healthy volunteers (HV). All were tested with CogTrack (an online cognitive assessment system) at baseline, and AN patients were tested again at a follow-up time point after weight increase (n = 13). At baseline, AN patients showed faster reaction times in the attention tasks, as well as increased accuracy in grammatical reasoning compared to HV. There were no differences in cognitive function between AN patients and HV in the other cognitive domains measured (sustained attention, working and episodic memory, speed of retrieval, and speed of grammatical reasoning). No differences were visible in the AN sample between baseline and follow-up. Performance did not correlate with any clinical variables in the AN sample. These findings supplement results from other studies suggesting increased concentration and reasoning accuracy in patients suffering from AN, who showed increased performance in cognitive tasks despite their illness.

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