Treatment of anorexia nervosa in a specialty care continuum

Abstract

Inpatient hospitalization has been a mainstay of treatment for anorexia nervosa (AN), but decreasing lengths of inpatient stay have prompted the development of alternative care-continuum models. This study characterizes the 6-month outcomes of 71 patients with AN who completed an inpatient-treatment protocol (approximately 5 weeks), followed by a day-hospital program (DHP) (approximately 3 weeks). Data were derived from chart reviews and questionnaire data were collected during routine clinical care. On discharge from DHP, 35.2% of patients showed excellent outcomes, whereas 23.9% exhibited poor outcomes. At 6 months after DHP discharge, 47.9% of the patients were successful in maintaining outpatient treatment status. Patients with successful 6-month outcomes were admitted to inpatient at a higher weight, had fewer previous hospitalizations, were younger, were rated by inpatient staff as more committed to treatment, endorsed less AN psychopathology during inpatient admission, and showed greater weight gain during DHP. Number of previous hospitalizations and weight gain immediately after inpatient discharge predicted 89.2% of outcome classifications 6 months after DHP discharge. These findings highlight both the potential benefits of this care-continuum model for patients who previously have not been hospitalized and the pressing need to develop alternative treatment strategies for patients with more chronic AN.