Background: Despite the increasing interest in the treatment of anorexia nervosa, no model of treatment has been shown to be consistently effective. Traditionally, treatment has been offered on an in-patient basis; however, more recently day treatment has been developed as a cost-effective alternative. Although day hospitalisation represents a potentially effective means of treatment, little has been published in the field in comparison to other models of care. St. George's Eating Disorder's Service additionally adopts two approaches to treating patients within the in-patient and day-patient settings: harm reduction and recovery. While recovery focuses on weight restoration, harm reduction assists patients in reaching a safe but low weight with the aim of improving quality of life. At present little is known about the effects of low-weight discharge on psychological outcome. Objectives: To compare the effectiveness of two models of treatment: in-patients and day-patients, by examining differences in eating disordered and general psychopathology at discharge, weight outcome, and patient satisfaction. Secondly, to compare the effectiveness of the harm reduction and recovery programmes. Methods: 52 participants meeting DSM-IV criteria for anorexia nervosa were recruited to compare treatment outcome. Results: No significant difference was detected at discharge between in-patients and day-patients on measures of eating disorder psychopathology, treatment satisfaction or weight outcome. In-patients, however, had more positive outcomes than day-patients regarding general psychopathology. Recovery patients demonstrated significantly better outcomes on levels of restraint than harm reduction patients, however, no other differences were observed regarding eating disorder outcome. Conclusions: While no significant difference was detected between groups on the majority of outcome measures, the small sample size limits the formation of reliable conclusions. There is preliminary evidence to suggest, however, that in-patients may facilitate better outcomes than day-patients regarding levels of general psychopathology and furthermore that weight restoration may have some benefits regarding improvements in restrictive eating behaviour for patients with anorexia nervosa.
| Identifer | oai:union.ndltd.org:bl.uk/oai:ethos.bl.uk:559384 |
| Date | January 2011 |
| Creators | Cockill, Lisa |
| Publisher | St George's, University of London |
| Source Sets | Ethos UK |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
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