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Published in: European Child & Adolescent Psychiatry 2/2009

01-02-2009 | ORIGINAL CONTRIBUTION

Predictive factors of length of inpatient treatment in anorexia nervosa

Authors: Luisa Strik Lievers, MD, Florence Curt, MD, PhD, Jenny Wallier, MS, Fabienne Perdereau, MD, Zoé Rein, MS, Philippe Jeammet, MD, PhD, Dr. Nathalie Godart, MD, PhD

Published in: European Child & Adolescent Psychiatry | Issue 2/2009

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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.
Literature
1.
go back to reference 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 35:509–521PubMedCrossRef 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 35:509–521PubMedCrossRef
2.
go back to reference American Psychiatric Association (2000) Practice guideline for the treatment of patients with eating disorders (revision). Am J Psychiatry 157:1–39 American Psychiatric Association (2000) Practice guideline for the treatment of patients with eating disorders (revision). Am J Psychiatry 157:1–39
3.
go back to reference American Psychiatric Association (1994) Diagnostic and statistic manual of mental disorders, 4th edn. American Psychiatric Association, Washington DC American Psychiatric Association (1994) Diagnostic and statistic manual of mental disorders, 4th edn. American Psychiatric Association, Washington DC
4.
go back to reference Cachelin FM, Maher BA (1998) Is amenorrhea a critical criterion for anorexia nervosa? J Psychosom Res 44:435–440PubMedCrossRef Cachelin FM, Maher BA (1998) Is amenorrhea a critical criterion for anorexia nervosa? J Psychosom Res 44:435–440PubMedCrossRef
5.
go back to reference Cochran WG (1954) Some methods for strengthening the common chi2. Tests Biometr 10:417–451CrossRef Cochran WG (1954) Some methods for strengthening the common chi2. Tests Biometr 10:417–451CrossRef
6.
go back to reference 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 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
8.
go back to reference 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 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.
go back to reference 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 9:224–227PubMed 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 9:224–227PubMed
10.
go back to reference Godart N, Perdereau F, Gales O, Agman G, Deborde AS, Jeammet P (2005) The weight contract during the hospitalization of anorexic patients. Arch Pediatr 12:1544–1550PubMedCrossRef Godart N, Perdereau F, Gales O, Agman G, Deborde AS, Jeammet P (2005) The weight contract during the hospitalization of anorexic patients. Arch Pediatr 12:1544–1550PubMedCrossRef
11.
go back to reference Golden NH, Jacobson MS, Schebendach J, Solanto MV, Hertz SM, Shenker (1997) Resumption of menses in anorexia nervosa. Arch Pediatr Adolesc Med 151:16–21PubMed Golden NH, Jacobson MS, Schebendach J, Solanto MV, Hertz SM, Shenker (1997) Resumption of menses in anorexia nervosa. Arch Pediatr Adolesc Med 151:16–21PubMed
12.
go back to reference Goodman R, Simonoff E (1991) Reliability of clinical rating scale by trainee child psychiatrists: a research note. J Child Psychopathol Psychiatry 32:551–555CrossRef Goodman R, Simonoff E (1991) Reliability of clinical rating scale by trainee child psychiatrists: a research note. J Child Psychopathol Psychiatry 32:551–555CrossRef
13.
go back to reference Herpertz-Dahlmann BM, Wewetzer C, Schulz E, Remschmidt H (1996) Course and outcome in adolescent anorexia nervosa. Int J Eat Disord 19:335–345PubMedCrossRef Herpertz-Dahlmann BM, Wewetzer C, Schulz E, Remschmidt H (1996) Course and outcome in adolescent anorexia nervosa. Int J Eat Disord 19:335–345PubMedCrossRef
14.
go back to reference Herzog DB, Keller MB, Lavori PW (1988) Outcome in anorexia nervosa and bulimia nervosa: a review of the literature. J Nerv Ment Dis 176:131–143PubMedCrossRef Herzog DB, Keller MB, Lavori PW (1988) Outcome in anorexia nervosa and bulimia nervosa: a review of the literature. J Nerv Ment Dis 176:131–143PubMedCrossRef
15.
go back to reference Huntley DA, Cho DW, Christman J, Csernansky JG (1998) Predicting length of stay in an acute psychiatric hospital. Psychiatr Serv 49:1049–1053PubMed Huntley DA, Cho DW, Christman J, Csernansky JG (1998) Predicting length of stay in an acute psychiatric hospital. Psychiatr Serv 49:1049–1053PubMed
17.
go back to reference Jeammet Ph (1984) Contrat et contraintes Dimensions psychologiques de l’hospitalisation dans le traitement de l’anorexique. Psychol Fr 29:137–143 Jeammet Ph (1984) Contrat et contraintes Dimensions psychologiques de l’hospitalisation dans le traitement de l’anorexique. Psychol Fr 29:137–143
18.
go back to reference Kahn C, Pike KM (2001) In search of predictors of dropout from inpatient treatment for anorexia nervosa. Int J Eat Disord 30:237–244PubMedCrossRef Kahn C, Pike KM (2001) In search of predictors of dropout from inpatient treatment for anorexia nervosa. Int J Eat Disord 30:237–244PubMedCrossRef
19.
go back to reference 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 37:741–747PubMedCrossRef 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 37:741–747PubMedCrossRef
20.
go back to reference 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 39:271–281PubMedCrossRef 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 39:271–281PubMedCrossRef
21.
go back to reference Ratnasuriya RH, Eisler Y, Smukler GI, Russel GFM (1991) Anorexia nervosa: outcome and prognosis factors after twenty years. Br J Psychiatry 158:495–502PubMedCrossRef Ratnasuriya RH, Eisler Y, Smukler GI, Russel GFM (1991) Anorexia nervosa: outcome and prognosis factors after twenty years. Br J Psychiatry 158:495–502PubMedCrossRef
22.
go back to reference 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):1347–1353PubMedCrossRef 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):1347–1353PubMedCrossRef
23.
go back to reference Robinson P (1993) Treatment for eating disorders in the United Kingdom. Part I. A survey on specialist services. Eur Eat Disord Rev 1:4–9CrossRef Robinson P (1993) Treatment for eating disorders in the United Kingdom. Part I. A survey on specialist services. Eur Eat Disord Rev 1:4–9CrossRef
24.
go back to reference 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):13–21PubMed 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):13–21PubMed
25.
go back to reference 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 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
26.
go back to reference Steinhausen HC, Seidel R (1993) Outcome in adolescent eating disorders. Int J Eat Disord 14:487–496PubMedCrossRef Steinhausen HC, Seidel R (1993) Outcome in adolescent eating disorders. Int J Eat Disord 14:487–496PubMedCrossRef
27.
go back to reference Steinhausen HC (2002) The outcome of anorexia nervosa in the 20th century. Am J Psychiatry 159:1284–1293PubMedCrossRef Steinhausen HC (2002) The outcome of anorexia nervosa in the 20th century. Am J Psychiatry 159:1284–1293PubMedCrossRef
28.
go back to reference 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 22:339–360PubMedCrossRef 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 22:339–360PubMedCrossRef
29.
go back to reference Watson TL, Andersen AE (2003) A critical examination of the amenorrhea and weight criteria diagnosing anorexia nervosa. Acta Psychiatr Scand 108:161–162CrossRef Watson TL, Andersen AE (2003) A critical examination of the amenorrhea and weight criteria diagnosing anorexia nervosa. Acta Psychiatr Scand 108:161–162CrossRef
30.
go back to reference Wiseman CV, Sunday RS, Klapper F, Harris WA, Halmi KA (2001) Changing patterns of hospitalisation in eating disorders patients. Int J Eat Disord 30:69–74PubMedCrossRef Wiseman CV, Sunday RS, Klapper F, Harris WA, Halmi KA (2001) Changing patterns of hospitalisation in eating disorders patients. Int J Eat Disord 30:69–74PubMedCrossRef
Metadata
Title
Predictive factors of length of inpatient treatment in anorexia nervosa
Authors
Luisa Strik Lievers, MD
Florence Curt, MD, PhD
Jenny Wallier, MS
Fabienne Perdereau, MD
Zoé Rein, MS
Philippe Jeammet, MD, PhD
Dr. Nathalie Godart, MD, PhD
Publication date
01-02-2009
Publisher
D. Steinkopff-Verlag
Published in
European Child & Adolescent Psychiatry / Issue 2/2009
Print ISSN: 1018-8827
Electronic ISSN: 1435-165X
DOI
https://doi.org/10.1007/s00787-008-0706-8

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