Abstract
The article presents a critical review regarding the premature termination of eating disorder’s treatment among inpatients and outpatients, with the aim of identifying—emotional, psychodynamic and family-related aspects involved. The search strategy used the following MeSH terms combined by Boolean operators: “eating disorders” AND “treatment” OR “patient dropouts” OR “drop-out/dropouts” OR “attrition” OR “premature termination” AND “empirical study” OR “qualitative research”, for on Medline/PUBMED, PsycINFO and EMBASE databases. This article follows the PRISMA Guidelines. A total of 26 studies composed this review, of which 24 were original research articles, 1 was a review and 1 a theoretical article. Only two articles applied qualitative methods analyzing categories of content obtained by in-depth interviews, three combine quantitative and qualitative methods and other three present qualitative analyses while discussing quantitative studies. Further qualitative studies should be carried out to clarify meanings of dropout, premature termination of treatment, and attrition. Different expectations held by patients and by therapeutic teams, and the interpersonal difficulties of these types of patients, stand out as difficulties in constructing “therapeutic alliances”, with impacts on dropout, premature termination and attrition rates.
Highlights
The landmark research study on dropout (DO) for eating disorders (ED) was published in 1983 [1]
In order to simplify the question of vocabulary, this review examines advances in research that focus on patient dropout, more technically termed “Premature Termination of Treatment” (PTT), to avoid the biases around the term DO noted by Sly [2], Campbell [3] and Wallier [4]
Treatment regimen: From a total of 26 articles, except the viewpoint article mention the regimen, we found a balanced distribution of studies focused on both treatment modalities: 12 inpatient [4] [9] [11]-[20] and 12 outpatient service [7] [8] [10] [21] [22] [23] [24] [25] and one analyzes both [26]
Summary
The landmark research study on dropout (DO) for eating disorders (ED) was published in 1983 [1]. This phenomenon is described as a complex and multifaceted reality that challenges clinicians and researchers. This review discusses some concepts in Eating Disorders field, methodological advances and changes that have occurred in the use of terms over the last decade. In order to simplify the question of vocabulary, this review examines advances in research that focus on patient dropout, more technically termed “Premature Termination of Treatment” (PTT), to avoid the biases around the term DO noted by Sly [2], Campbell [3] and Wallier [4]
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