Predictive factors of length of inpatient treatment in anorexia nervosa

International audienc

Predictive factors of length of inpatient treatment in anorexia nervosa

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

Is major depressive episode related to anxiety disorders in anorexics and bulimics ?

Objective: To determine whether the presence of anxiety disorders is related to depressive comorbidity in subjects with eating disorders (ED), while taking into account certain variables that may be related to depression (subjects' age, ED duration, prior incidents of anorexia nervosa in bulimic subjects, inpatient or outpatient status, nutritional state [as measured by body mass index]). Method: We evaluated the frequency of depressive disorders in 271 subjects presenting with a diagnosis of either anorexia nervosa or bulimia, using the Mini International Neuropsychiatric Interview, DSM-IV version. Results: A multivariate analysis reveals that anxiety disorders do not all have the same influence in terms of risk of onset of major depressive episode in anorexics and bulimics when adjusted on variables related to depression. Conclusion: Depression in subjects with ED can be explained in part by comorbidity with obsessive-compulsive disorder, generalized anxiety, social phobia, and panic disorder. (c) 2006 Published by Elsevier In

Does the frequency of anxiety and depressive disorders differ between diagnostic subtypes of anorexia nervosa and bulimia?

Objective: The objective of the present work is to determine whether the prevalence of depressive and anxiety disorders varies in subgroups of eating disorders (ED) according to age, ED duration, mode of care provision, and body mass index (BMI). Method: Using the Mini International Neuropsychiatric Interview (MINI), the frequency of anxiety and depressive disorders was evaluated in 271 ED participants. Their prevalence was compared in subgroups of anorexics (AN-R and AN-BN) and bulimics (BN), both before and after controlling for potential confounding variables. Results: Current or lifetime comorbidity of anxiety and depressive disorders did not differ between AN-R and AN-BN groups. Social phobia, panic disorders, and obsessive-compulsive disorder (OCD) were significantly more frequent in AN-BN and AN-R groups. Panic disorder was more frequent in the BN group. Conclusion: Several confounding factors, in particular those identified in the present study, may explain previous conflicting results on the frequency of anxiety and depressive disorders in ED. Nevertheless, the study confirmed that OCD is more frequent in AN, even after controlling for confounding factors

Flow chart of the randomized control trial.

<p>TAU: treatment as usual; TAU+FT: treatment as usual and family therapy.</p

Secondary Outcome (ITTA).

<p>Abbreviations: MR: Morgan and Russell; GOAS ^: Global Outcome Assessment Scale; ITTA: intention to treat analysis; TAU: treatment as usual; TAU+FT: treatment as usual and family therapy; SAS: Social Adjustment Scale; SD standard deviation; 95% CI: 95% confidence interval.</p><p>*Relative effect size: odd ratio for qualitative variables; Cohen's d for quantitative variables.</p