Abstract
Background: Manualized Family Based Therapy (FBT) is the treatment of choice for adolescent anorexia nervosa, but it is an outpatient treatment. Very little research has examined whether or how the principles of FBT might be successfully adapted to an inpatient setting, and there is little other evidence in the literature to guide us on how to best treat children and adolescents with eating disorders (EDs) while in hospital. This paper describes and provides treatment outcomes for an intensive inpatient program that was designed for the treatment of adolescents less than 18 years of age with severe anorexia nervosa, based on the principles of FBT. Each patient’s family was provided with FBT adapted for an inpatient setting for the duration of the admission. Parents were encouraged to provide support for all meals in hospital and to plan meal passes out of hospital.Methods: A retrospective cohort study was conducted that examined the outcomes of 153 female patients admitted over a 5-year period. Outcome data focused primarily on weight change as well as psychological indicators of health (i.e., depression, anxiety, ED psychopathology).Results: Paired t-tests with Bonferroni corrections showed significant weight gain associated with a large effect size. In addition, patients showed improvements in scores of mood, anxiety, and ED psychopathology (associated with small to medium effect sizes), though they continued to display high rates of body dissatisfaction and some ongoing suicidality at the time of discharge.Conclusion: This study shows that a specialized inpatient program for adolescents with severe EDs that was created using the principles of FBT results in positive short-term medical and psychological improvements as evidenced by improved weight gain and decreased markers of psychological distress.
Highlights
Eating disorders (EDs) are serious and potentially lifethreatening conditions that typically have their peak age of onset in adolescence [1], with anorexia nervosa (AN) being the third most common chronic illness in adolescent females [2]
English was the most common primary language spoken at home (69.6%), and interestingly, only a minority of patients lived with married parents (47.8%)
11.8% of parents reported their child as having an individualized education plan (IEP) and 7.5% of patients as having a recognized learning disability
Summary
Eating disorders (EDs) are serious and potentially lifethreatening conditions that typically have their peak age of onset in adolescence [1], with anorexia nervosa (AN) being the third most common chronic illness in adolescent females [2]. Since FBT is an outpatient treatment, little research has examined whether or how the principles of FBT might be successfully adapted to an inpatient setting, and there is little other evidence in the literature to guide us on how to best treat children and adolescents with EDs while in hospital. Very little research has examined whether or how the principles of FBT might be successfully adapted to an inpatient setting, and there is little other evidence in the literature to guide us on how to best treat children and adolescents with eating disorders (EDs) while in hospital. Parents were encouraged to provide support for all meals in hospital and to plan meal passes out of hospital
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