Hospital treatment of anorexia nervosa: A 25 year retrospective study form 1958 to 1982

Abstract

In order to characterize changes in the presenting symptomatology and treatment of anorexia nervosa (AN), the hospital charts of 76 anorexia nervosa patients were reviewed from three time periods: (1) 1958-1962, (II) 1968-1972, and (III) 1978-1982. In period 1, 92% of the patients were admitted to a medicine service, whereas in period III, 92% were admitted to psychiatry. Age of onset, percent mean weight for height upon admission, and reported frequencies of laxative use and vomiting showed no statistical differences among the periods. Lenght of hospital stay and weight gained during hospitalization increased significantly during period III, with similar stays occurring for both vomiters and restrictors. Between periods I and III the number of medical diagnostic studies decreased while the frequency of behavioral therapies and use of antidepressant medication in creased. During the past 25 years, theories of etiology and approaches to treatment of anorexia nervosa have become increasingly psychiatric. We postulate that the apparent increasing incidence of AN may partially be attributable to an underdiagnosis of AN by medical services in the past.