OBJECTIVE: Compulsory in-patient refeeding of patients with severe anorexia nervosa (AN) has caused considerable controversy. The effects of such treatment on longer-term outcome are not well known. The objective of this article is to review the evidence on the outcome of compulsory treatment for AN. METHOD: Three large databases were searched for studies regarding compulsory treatment in AN. RESULTS: Detained patients have more severe symptoms and comorbidity and a longer duration of inpatient stay. In the short term compulsory refeeding in AN appears to be beneficial, but the longer term effects remain uncertain. Clinicians report no worsening of the therapeutic relationship after compulsory treatment. DISCUSSION: In severe cases of AN where the patient refuses life-saving treatment compulsory treatment needs to be considered. Future research should focus on the longer term effects of compulsory treatment and also on questions related to mental capacity in AN.
OBJECTIVE: Compulsory in-patient refeeding of patients with severe anorexia nervosa (AN) has caused considerable controversy. The effects of such treatment on longer-term outcome are not well known. The objective of this article is to review the evidence on the outcome of compulsory treatment for AN. METHOD: Three large databases were searched for studies regarding compulsory treatment in AN. RESULTS: Detained patients have more severe symptoms and comorbidity and a longer duration of inpatient stay. In the short term compulsory refeeding in AN appears to be beneficial, but the longer term effects remain uncertain. Clinicians report no worsening of the therapeutic relationship after compulsory treatment. DISCUSSION: In severe cases of AN where the patient refuses life-saving treatment compulsory treatment needs to be considered. Future research should focus on the longer term effects of compulsory treatment and also on questions related to mental capacity in AN.
Authors: George C Patton; Susan M Sawyer; John S Santelli; David A Ross; Rima Afifi; Nicholas B Allen; Monika Arora; Peter Azzopardi; Wendy Baldwin; Christopher Bonell; Ritsuko Kakuma; Elissa Kennedy; Jaqueline Mahon; Terry McGovern; Ali H Mokdad; Vikram Patel; Suzanne Petroni; Nicola Reavley; Kikelomo Taiwo; Jane Waldfogel; Dakshitha Wickremarathne; Carmen Barroso; Zulfiqar Bhutta; Adesegun O Fatusi; Amitabh Mattoo; Judith Diers; Jing Fang; Jane Ferguson; Frederick Ssewamala; Russell M Viner Journal: Lancet Date: 2016-05-09 Impact factor: 79.321