Inpatient versus Day Clinic Treatment for Bulimia Nervosa: A Randomized Trial

Department of Psychosomatic Medicine and Psychotherapy, University of Freiburg, Hauptstrasse 8, Freiburg, Germany.
Psychotherapy and Psychosomatics (Impact Factor: 9.2). 04/2009; 78(3):152-60. DOI: 10.1159/000206869
Source: PubMed


In bulimia nervosa, more intense treatments are recommended if outpatient treatment fails. This is the first randomized controlled trial comparing the options of inpatient versus day clinic treatment.
Patients with severe bulimia nervosa were randomly assigned to inpatient or day clinic treatment of similar length and intensity. Specific and general psychopathology was assessed at the end of treatment and a 3-month follow-up.
Fifty-five patients were randomized; 22 day clinic patients and 21 inpatients started the program. At the end of treatment, a significant reduction of general and specific pathology was found in both settings. Following discharge, there was more deterioration in bulimic symptoms after inpatient treatment, but overall, results were comparable.
Inpatient and day clinic programs are effective treatments for severely disturbed bulimic patients with similar results at the 3-month follow-up. Further follow-up will show if a higher instability of results after inpatient treatment is of importance in the long term.

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    • "Advantages of day hospital treatment include the daily transfer of experiences (home ↔ hospital) and an emphasis on self-reliance. This might allow an easier transfer of experiences into everyday life and reduce the risk for relapse (Zeeck et al., 2009c, 2009d; Mörtl, von Wietersheim, 2008). However, inpatient treatment can be considered more " safe and containing " as patients are accommodated in their own rooms and staff is available for 24 hours. "
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