This study aimed to identify predictors of acceptance of intensive treatment and of participation in a randomized controlled trial (RCT) among women with anorexia nervosa (AN).
Participant data were drawn from a tertiary care intensive treatment programme including a previously published RCT. Women with AN (N = 106) were offered intensive treatment, and 69 were approached to participate in an RCT of olanzapine's efficacy as an adjunctive treatment for AN. AN subtype and pretreatment psychological variables were used to predict acceptance of intensive treatment and RCT participation.
AN binge purge subtype and higher depression and body dissatisfaction predicted intensive treatment acceptance. No variable predicted RCT participation among treatment acceptors.
Clinicians may focus on enhancing motivation or use a stepped care approach to increase intensive treatment acceptance especially among women with AN-restricting type and among all those with AN who have lower levels of distress.
"Halmi et al  suggest that among people with anorexia nervosa, a high level of obsessive preoccupations, assessed by the Yale-Brown-Cornell Eating Disorder scale, is a predictive factor for the acceptance of care involving cognitive-behavioural therapy, with or without treatment by fluoxetine. Compared with patients with purely restrictive anorexia nervosa, those with bulimic anorexia or purging behaviour may accept in-hospital treatment more easily, according to Tasca et al . The same appears true for patients with depressive symptoms or strong body dissatisfaction, independently of type of anorexia nervosa. "
[Show abstract][Hide abstract] ABSTRACT: Anorexia nervosa is a severe psychiatric disorder mainly affecting women. Its treatment is long and accepted with much difficulty, in particular in-patient treatment.
To describe the subjective motives of women with anorexia nervosa for requesting in-patient admission, from a qualitative analysis of application letters.
Participants were adult women (18 years and older) with anorexia nervosa who were admitted as in-patients in a referral hospital unit in France from January 2008 to December 2010. The application letters, prerequisites to admission, were studied by the interpretative phenomenological method of content analysis.
63 letters have been analysed, allowing the identification of six themes related to requests for in-patient care: loss of control of behaviour, and of thoughts, mental exhaustion, isolation, inner struggle and fear of recovery.
Requests for in-patient admission were motivated by very personal, subjective experiences, unrelated to medical reasons for admission. These results may help improve pre-admission motivational work with individuals, by basing it on their subjective experience.
PLoS ONE 10/2013; 8(10):e77757. DOI:10.1371/journal.pone.0077757 · 3.23 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Abstract Psychological interventions and research for eating disorders tend to be complex, and outcomes on average are modest. Given the frequency and severity of eating disorders, these levels of outcomes are disconcerting. Adding to the current state of research is evidence that practicing clinicians do not tend to use evidence-based psychotherapies consistently for eating disorders. This is a problem not only of dissemination and uptake of research, but also one of knowledge translation. More practice-based research, in which clinicians are equal partners in developing interventions and designing research, may be necessary in order to solve the problems of modest outcomes and low research uptake. The psychotherapy research of eating disorders in this special section presents examples of research that takes place in real-world clinical contexts with complex patients and that can be more easily translated into clinical practice.
Psychotherapy Research 05/2013; 23(3):247-251. DOI:10.1080/10503307.2013.796425 · 1.75 Impact Factor
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