4.4 Article

Outcomes for adults with anorexia nervosa who do not respond early to outpatient treatment

Journal

INTERNATIONAL JOURNAL OF EATING DISORDERS
Volume 54, Issue 7, Pages 1278-1282

Publisher

WILEY
DOI: 10.1002/eat.23508

Keywords

anorexia nervosa; early response; functional impairment; good outcome; treatment

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Good outcome was achieved by 23% of patients, with greater functional impairment at baseline predicting good outcome. Remission was achieved by 15% of patients. Further work identifying sub-groups of patients who do not achieve good outcome after treatment will inform targeted engagement approaches.
Objective To better understand those patients with anorexia nervosa who do not show early response to treatment and are likely to have poorer outcome. Method From an existing data set of 187 patients with anorexia nervosa across 22 eating disorder outpatient services in the United Kingdom, participants who had started treatment and had at least one body mass index (BMI) observation in the first 6 weeks of treatment were eligible for these secondary analyses (N = 65), a latent class analysis of BMI change over the first 6 weeks of treatment. Fifty-six patients showed no early change in BMI. We used logistic regression to examine predictors of good outcome in the 40 participants who had 12-month follow-up data. Predictors included global EDE-Q, negative affect (Depression, Anxiety, and Stress Scales) and functional impairment (Work and Social Adjustment Scale). Results Good outcome was achieved by 23% of patients and remission by 15%. Good outcome was predicted by greater functional impairment at baseline. Discussion Further work that can identify sub-groups of patients with anorexia nervosa who do not achieve good outcome after treatment will inform the development of targeted engagement approaches.

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