Abstract
Objectives
Anorexia Nervosa (AN) treatment is frequently associated with high costs often due to the use of hospitalization. In Family Based Treatment (FBT) a main goal is to manage recovery of AN in the home environment rather than relying on lengthy hospital admissions. This study examined whether the use of hospitalization altered following the introduction of FBT to a youth eating disorders program in 2009.
Method
This study compared retrospective data of 71 female adolescent patients diagnosed with AN: 10 who received treatment as usual prior to the implementation of FBT; 10 who were treated immediately after FBT implementation; and a further 51 adolescents who received FBT since 2009.
Results
Results indicate that since the implementation of FBT there was a significant reduction in admissions to the medical ward and a significant reduction in cumulative length of stay on both the psychiatric and medical wards in adolescents presenting with AN.
Acknowledgments
This research was conducted as part of a Master in Clinical Psychology degree for Hayley Thompson at Griffith University, Gold Coast, Australia. No sponsor or grant was sought for this research
Research funding: None declared.
Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.
Competing interests: Authors state no conflict of interest.
Informed consent: The Institutional Review Board determined that informed consent from individuals included in this study was not required.
Ethical approval: The local Institutional Review Board reviewed and approved the study HREC/16/QGC/107.
References
1. Swanson, S, Crow, S, Le Grange, D, Swendsen, J, Merikangas, K. Prevalence and correlates of eating disorders in adolescents: results from the national comorbidity survey replication adolescent supplement. Arch Gen Psychiatr 2011;68:714–23. https://doi.org/10.1001/archgenpsychiatry.2011.22.Search in Google Scholar PubMed PubMed Central
2. Gatt, L, Jan, S, Mondraty, N, Horsfield, S, Hart, S, Russell, J, et al.. The household economic burden of eating disorders and adherence to treatment in Australia. BMC Psychiatr 2014;14:338. https://doi.org/10.1186/s12888-014-0338-0.Search in Google Scholar PubMed PubMed Central
3. American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 5th ed. Washington, DC: Text Revised; 2013.10.1176/appi.books.9780890425596Search in Google Scholar
4. Madden, S, Morris, A, Zurynski, YA. Burden of eating disorders in 5–13 year old children in Australia. Med J Aust 2009;190:410–14. https://doi.org/10.5694/j.1326-5377.2009.tb02487.x.Search in Google Scholar PubMed
5. Treasure, J, Russell, G. The case for early intervention in anorexia nervosa: theoretical exploration of maintaining factors. Br J Psychiatr 2011;199:5–7. https://doi.org/10.1192/bjp.bp.110.087585.Search in Google Scholar PubMed
6. Kazdin, AE, Fitzsimmons-Craft, EE, Wilfley, DE. Addressing critical gaps in the treatment of eating disorders. Int J Eat Disord 2017;50:170–89. https://doi.org/10.1002/eat.22670.Search in Google Scholar PubMed PubMed Central
7. Crow, SJ, Nyman, JA. The cost-effectiveness of anorexia nervosa treatment. Int J Eat Disord 2004;35:155–60. https://doi.org/10.1002/eat.10258.Search in Google Scholar PubMed
8. Golden, NH, Katzman, DK, Kreipe, RE, Stevens, SL, Sawyer, SM, Rees, J, et al.. Eating disorders in adolescents. J Adolesc Health;33:496–503. https://doi.org/10.1016/j.jadohealth.2003.08.004.Search in Google Scholar
9. Katzman, DK. Medical complications in adolescents with anorexia nervosa: a review of the literature. Int J Eat Disord 2005;37:52–9. https://doi.org/10.1002/eat.20118.Search in Google Scholar PubMed
10. Meads, C, Gold, L, Burls, A. How effective is outpatient care compared to inpatient care for the treatment of anorexia nervosa? a systematic review. Eur Eat Disord Rev 2001;9:229–41. https://doi.org/10.1002/erv.406.Search in Google Scholar
11. National Institute for Clinical Excellence. Eating disorders: recognition and treatment. London: National Institute for Clinical Excellence; 2017.Search in Google Scholar
12. Lock, J, LeGrange, D, Agras, W, Dare, C. Treatment manual for anorexia nervosa: a family-based approach. New York: Guilford Press; 2001.Search in Google Scholar
13. Lock, J, LeGrange, D. Treatment manual for anorexia nervosa: a family-based approach, 2nd ed. New York: Guilford Press; 2012.10.1002/9781118269848.ch8Search in Google Scholar
14. Nichols, M, Schwartz, R. Family therapy: concepts and methods, 7th ed. Boston: Pearson/Allyn & Bacon; 2006.Search in Google Scholar
15. Agras, W, Lock, J, Brandt, H, Bryson, SW, Dodge, E, Halmi, KA, et al.. Comparison of 2 family therapies for adolescent anorexia nervosa: a randomized parallel trial. JAMA Psychiatry 2014;71:1279–86. https://doi.org/10.1001/jamapsychiatry.2014.1025.Search in Google Scholar PubMed PubMed Central
16. Lock, J, LeGrange, D, Agras, S, Moye, A, Bryson, S, Booil, J. Randomized clinical trial comparing family-based treatment with adolescent-focused individual therapy for adolescents with anorexia nervosa. Arch Gen Psychiatr 2010;67:1025–32. https://doi.org/10.1001/archgenpsychiatry.2010.128.Search in Google Scholar PubMed PubMed Central
17. Wallis, A, Rhodes, P, Kohn, M, Madden, S. Five-years of family based treatment for anorexia nervosa: the maudsley model at the children’s hospital at Westmead. Int J Adolesc Med Health 2007;19:277–83. https://doi.org/10.1515/ijamh.2007.19.3.277.Search in Google Scholar PubMed
18. Hughes, EK, Le Grange, D, Court, A, Yeo, M, Campbell, S, Whitelaw, M, et al.. Implementation of family-based treatment for adolescents with anorexia nervosa. J Pediatr Health Care: Off Publ Natl Assoc Pediatr Nurse Assoc Pract 2014;28:322–30. https://doi.org/10.1016/j.pedhc.2013.07.012.Search in Google Scholar PubMed
19. American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 4th ed. Washington: Text Revised; 2000.Search in Google Scholar
20. Kuczmarski, R, Ogden, C, Guo, S, Grummer-Strawn, L, Flegal, K, Mei, Z, et al.. CDC growth charts for the United States: methods and development. Vital and health statistics series 11. Data Natl Health Surv 2000;2002:1–190.Search in Google Scholar
21. Gowers, SG, Clark, A, Roberts, C, Griffiths, A, Edwards, V, Bryan, C, et al.. Clinical effectiveness of treatments for anorexia nervosa in adolescents: randomised controlled trial. Br J Psychiatr 2007;191:427–35. https://doi.org/10.1192/bjp.bp.107.036764.Search in Google Scholar PubMed
22. Rhodes, P, Madden, S. Scientist-practitioner family therapists, postmodern medical practitioners and expert parents: second-order change in the eating disorders program at the children’s hospital at Westmead. J Fam Ther 2005;27:171–82. https://doi.org/10.1111/j.1467-6427.2005.00309.x.Search in Google Scholar
23. Independent Hospital Pricing Authority. National efficient price determination 2014–15. Sydney, Australia: Commonwealth of Australia; 2014.Search in Google Scholar
24. Katzman, DK, Golden, NH, Neumark-Sztainer, D, Yager, J, Strober, M. From prevention to prognosis: clinical research update on adolescent eating disorders. Pediatr Res 2000;47:709–12. https://doi.org/10.1203/00006450-200006000-00005.Search in Google Scholar PubMed
© 2020 Walter de Gruyter GmbH, Berlin/Boston
Articles in the same Issue
- Review
- Declining age at menarche in Indonesia: a systematic review and meta-analysis
- Original Articles
- Implementing family based treatment in a child and youth eating disorder program: impact on admissions
- High incidence of concussion, but low knowledge levels among young adults
- Socio-cognitive factors influencing Greek lyceum female students’ intention to receive a Pap smear and a vaccine against HPV
- Predictors of sun protection behavior in high school students of Ahvaz: a cross-sectional study
- The associations between sleep duration and sleep quality with self-rated health in young adults: a population-based study
- Unpreparedness, impurity and paradoxical feeling: menstruation narratives of Iranian women
- Changes in weight, physical activity and its theory-based psychosocial correlates within an adolescent bariatric clinic: contrasts with adults with extreme obesity
- Mechanisms of change of traditional mindfulness practice in Thai adolescent students: a cross-sectional mediation study
- Resilience among secondary school students in South-Western Nigeria; association with abuse and neglect
- Physical activity and physical fitness as protective factors of adolescent health
- On the question of non-medical cognitive enhancers among in-school adolescents: prevalence, predictors and potential health-related harms
- Overweight or obesity and related lifestyle and psychosocial factors among adolescents in Brunei Darussalam
- Traversing the liminal: what can Fontan adults’ transition experiences and perspectives teach us about optimizing healthcare?
- Perception of parenting styles by in-school adolescents in South-West Nigeria
- Socioeconomic status is a predictor of neurocognitive performance of early female adolescents
- Retraction
- Retraction of: Assessment of academic performance of licensed athletes
Articles in the same Issue
- Review
- Declining age at menarche in Indonesia: a systematic review and meta-analysis
- Original Articles
- Implementing family based treatment in a child and youth eating disorder program: impact on admissions
- High incidence of concussion, but low knowledge levels among young adults
- Socio-cognitive factors influencing Greek lyceum female students’ intention to receive a Pap smear and a vaccine against HPV
- Predictors of sun protection behavior in high school students of Ahvaz: a cross-sectional study
- The associations between sleep duration and sleep quality with self-rated health in young adults: a population-based study
- Unpreparedness, impurity and paradoxical feeling: menstruation narratives of Iranian women
- Changes in weight, physical activity and its theory-based psychosocial correlates within an adolescent bariatric clinic: contrasts with adults with extreme obesity
- Mechanisms of change of traditional mindfulness practice in Thai adolescent students: a cross-sectional mediation study
- Resilience among secondary school students in South-Western Nigeria; association with abuse and neglect
- Physical activity and physical fitness as protective factors of adolescent health
- On the question of non-medical cognitive enhancers among in-school adolescents: prevalence, predictors and potential health-related harms
- Overweight or obesity and related lifestyle and psychosocial factors among adolescents in Brunei Darussalam
- Traversing the liminal: what can Fontan adults’ transition experiences and perspectives teach us about optimizing healthcare?
- Perception of parenting styles by in-school adolescents in South-West Nigeria
- Socioeconomic status is a predictor of neurocognitive performance of early female adolescents
- Retraction
- Retraction of: Assessment of academic performance of licensed athletes