Background
Anorexia Nervosa (AN) is a serious disorder, with high costs due to hospitalisation. International treatments vary with prolonged hospitalisations in Europe and shorter hospitalisations in the USA. Uncontrolled studies suggest longer initial hospitalisations that normalise weight produce better outcomes and less admissions than shorter hospitalisations with lower discharge weights.
Methods
A randomised controlled trial of 82 adolescents, with DSM-IV AN and medical instability comparing brief hospitalisation for medical stabilisation (MS) and hospitalisation for weight restoration (WR) to 90% expected body weight (EBW) (1:1), both followed by 20 sessions of manualised, family based treatment (FBT).
Results
Primary outcome was hospital days, following initial admission, at 12-month follow-up. Secondary outcomes were total hospital days to 12-months and full remission (EBW>95% and global Eating Disorder Examination score within 1 SD of published means). There was no significant difference between groups in hospital days used following initial admission. There were significantly more total hospital days used and post-protocol FBT sessions in the WR group. There were no moderators of primary outcome, but participants with higher eating psychopathology and compulsive features reported better outcomes in the MS group.
Conclusions
Outcomes are similar with hospitalisations for MS or WR when combined with FBT. Cost savings would result from combining shorter hospitalisation with FBT.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
This article is published under an open access license. Please check the 'Copyright Information' section either on this page or in the PDF for details of this license and what re-use is permitted. If your intended use exceeds what is permitted by the license or if you are unable to locate the licence and re-use information, please contact the Rights and Permissions team.
About this article
Cite this article
Madden, S., Miskovic-Wheatley, J., Wallis, A. et al. A randomised controlled trial of in-patient treatment for anorexia nervosa in medically unstable adolescents. J Eat Disord 3 (Suppl 1), O44 (2015). https://doi.org/10.1186/2050-2974-3-S1-O44
Published:
DOI: https://doi.org/10.1186/2050-2974-3-S1-O44