Outcome of adolescents with eating disorders from an adolescent medicine service at a large children's hospital.

Abstract

To describe outcomes of adolescents with eating disorders treated by an interdisciplinary adolescent medicine service at a large children's hospital and to identify factors, including hospitalization, associated with outcome. The study design was a retrospective chart review of patients. The setting was an inpatient and outpatient adolescent service in a large urban children's hospital. A total of 218 adolescents diagnosed with anorexia nervosa, bulimia nervosa, or eating disorder not otherwise specified participated in the study. Interdisciplinary inpatient and outpatient treatment for eating disorders was adopted for intervention. Patient outcomes were categorized as fully recovered, partially recovered/improved, or poorly recovered/exhibiting chronicity. Being admitted to the study hospital once and longer duration of follow-up were associated with full or partial recovery. In contrast, being readmitted to the study hospital and longer duration of illness prior to the initial contact with this service were associated with poor recovery. Premorbid obesity was unrelated to outcome. Earlier detection and referral of adolescents with eating disorders are needed because a high percentage of patients, especially those with anorexia nervosa, required hospitalization at initial contact. The benefits of inpatient admission may extend beyond medical stabilization of the most medically compromised patients to include improved therapeutic relationship with the treatment team and improved follow-up. Many patients prematurely terminate treatment; factors contributing to premature termination of therapy need further exploration.