OBJECTIVE: Our aim is to present clinical results achieved with an intensive treatment programme for severe anorexia nervosa (AN) patients at risk of severe disability or death. Aims of the treatment are to remove life threatening conditions, physical and nutritional rehabilitation, and psychological and relational rehabilitation. METHODS: We present an observational retrospective study of a cohort of 99 consecutive patients affected by severe AN [according to Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR)] and a body mass index (BMI) <or=13.5 kg/m2 treated by a multidisciplinary comprehensive medical, nutritional, psychological treatment. Intensive treatment (inpatient day and night and day hospital care) of variable length, with resort to enteral nutrition if needed, ends by achieving a BMI of at least 18 kg/m2. Outpatient care phase follows. Main goals were the recovery of BMI and the ability to maintain it. RESULTS: Ninety-nine patients affected by severe Protein- Energy-Malnutritrion (PEM) due to AN were eligible in the study. Mean BMI was 12.5+/-0.9 kg/m2, mean age 21.9+/-8.6 yrs. Of 99 patients, 75 (75.5%) completed the planned treatment (completer subgroup). Eighteen patients prematurely interrupted their treatment before achieving complete weight restoration (dropout subgroup); on average they were older and ill for a longer time before admission. Six patients asked to be transferred to other eating disorder units closer to their towns. Seventy-five completer AN patients continued to undergo intensive inpatient treatment till the achievement of BMI 18.3+/-0.8 kg/m2 and then they have been in follow-up outpatient for a mean period of 17.4+/-1.6 months with an average extra increase of their BMI until to 19.1+/-1.6 kg/m2. In 32 patients with a more severe malnutrition we had to resort to nasogastric enteral feeding for 4.4+/-2.5 months, with a mean caloric supply of 1375+/-211 Kcal until the patients were no longer at life risk and they started to co-operate to treatment, increasing oral food amounts. DISCUSSION: Our results seem to provide strong support for using a highly structured program for treating patients with severe AN, including inpatient care and multidisciplinary medical and psychological teams specialized in eating disorder treatment.
OBJECTIVE: Our aim is to present clinical results achieved with an intensive treatment programme for severe anorexia nervosa (AN) patients at risk of severe disability or death. Aims of the treatment are to remove life threatening conditions, physical and nutritional rehabilitation, and psychological and relational rehabilitation. METHODS: We present an observational retrospective study of a cohort of 99 consecutive patients affected by severe AN [according to Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR)] and a body mass index (BMI) <or=13.5 kg/m2 treated by a multidisciplinary comprehensive medical, nutritional, psychological treatment. Intensive treatment (inpatient day and night and day hospital care) of variable length, with resort to enteral nutrition if needed, ends by achieving a BMI of at least 18 kg/m2. Outpatient care phase follows. Main goals were the recovery of BMI and the ability to maintain it. RESULTS: Ninety-nine patients affected by severe Protein- Energy-Malnutritrion (PEM) due to AN were eligible in the study. Mean BMI was 12.5+/-0.9 kg/m2, mean age 21.9+/-8.6 yrs. Of 99 patients, 75 (75.5%) completed the planned treatment (completer subgroup). Eighteen patients prematurely interrupted their treatment before achieving complete weight restoration (dropout subgroup); on average they were older and ill for a longer time before admission. Six patients asked to be transferred to other eating disorder units closer to their towns. Seventy-five completer AN patients continued to undergo intensive inpatient treatment till the achievement of BMI 18.3+/-0.8 kg/m2 and then they have been in follow-up outpatient for a mean period of 17.4+/-1.6 months with an average extra increase of their BMI until to 19.1+/-1.6 kg/m2. In 32 patients with a more severe malnutrition we had to resort to nasogastric enteral feeding for 4.4+/-2.5 months, with a mean caloric supply of 1375+/-211 Kcal until the patients were no longer at life risk and they started to co-operate to treatment, increasing oral food amounts. DISCUSSION: Our results seem to provide strong support for using a highly structured program for treating patients with severe AN, including inpatient care and multidisciplinary medical and psychological teams specialized in eating disorder treatment.
Authors: A L Robin; P T Siegel; A W Moye; M Gilroy; A B Dennis; A Sikand Journal: J Am Acad Child Adolesc Psychiatry Date: 1999-12 Impact factor: 8.829
Authors: Stephan Zipfel; Deborah L Reas; Chris Thornton; Marion P Olmsted; Donald A Williamson; Monika Gerlinghoff; Wolfgang Herzog; Peter J Beumont Journal: Int J Eat Disord Date: 2002-03 Impact factor: 4.861
Authors: Neville H Golden; Debra K Katzman; Richard E Kreipe; Sarah L Stevens; Susan M Sawyer; Jane Rees; Dasha Nicholls; Ellen S Rome Journal: J Adolesc Health Date: 2003-12 Impact factor: 5.012
Authors: Pierre Beumont; Phillipa Hay; Daphne Beumont; Laird Birmingham; Harry Derham; Amanda Jordan; Michael Kohn; Brett McDermott; Peta Marks; Jim Mitchell; Susan Paxton; Lois Surgenor; Chris Thornton; Alison Wakefield; Sue Weigall Journal: Aust N Z J Psychiatry Date: 2004-09 Impact factor: 5.744
Authors: Jennifer Dominguez; Linnea Goodman; Surupa Sen Gupta; Laurel Mayer; Sarah Fischer Etu; B Timothy Walsh; Jack Wang; Richard Pierson; Michelle P Warren Journal: Am J Clin Nutr Date: 2007-07 Impact factor: 7.045