Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-745bb68f8f-kw2vx Total loading time: 0 Render date: 2025-02-11T05:23:37.691Z Has data issue: false hasContentIssue false

42 - Complex treatments for eating disorders

from Part III - Specific treatments

Published online by Cambridge University Press:  12 May 2010

By
Scott Crow  and
Ulrike Schmidt
Edited by
Peter Tyrer  and
Kenneth R. Silk
Scott Crow
Affiliation:
Department of Psychiatry University of Minnesota Medical School Minneapolis, MN USA
Ulrike Schmidt
Affiliation:
Institute of Psychiatry De Crespigny Park London UK
Peter Tyrer
Affiliation:
Imperial College of Science, Technology and Medicine, London
Kenneth R. Silk
Affiliation:
University of Michigan, Ann Arbor
Get access

Summary

Editor's note

The decision of where to treat anorexia and bulimia nervosa, and for how long, is a critical part of management. The agonizing that goes into the decision whether to seek treatment at all has been well illustrated in the popular UK radio series The Archers in which one of the central characters, Helen Archer, developed excessive dieting and marked loss of weight after the suicide of her partner. (For some reason the script writers insisted her condition was not anorexia nervosa, so they might have been thinking of EDNOS – see Chapter 39.) The difficult task her parents had in getting her to seek treatment – ‘there is nothing wrong with me, mum, why do you have to try and control my life?’ – and the subtle and delicate way it was finally achieved, shows the importance of matching the treatment of eating disorders to the right setting. This subject, like most complex interventions, is unfortunately not at the stage of giving evidence-based guidelines but at some point the major differences between the type and duration of treatment in different countries will need to be addressed through some formal comparisons.

Introduction

For the greater part of the twentieth century management of anorexia nervosa (AN) was in the hands of non-psychiatrist physicians, and these patients were usually nursed on general medical wards. With the development of psychological models of anorexia nervosa, management of this condition transferred from general medicine to psychiatry or in some European countries to psychosomatic medicine.

Type
Chapter
Information
Cambridge Textbook of Effective Treatments in Psychiatry , pp. 647 - 656
Publisher: Cambridge University Press
Print publication year: 2008

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Psychiatric Association (2000). Practice guideline for the treatment of patients with eating disorders (revision). American Journal of Psychiatry, 157 (suppl. 1), 1–39.
Bemis, K. M. (1987). The present status of operant conditioning for the treatment of anorexia nervosa. Behavior Modification, 11, 432–63.Google Scholar
Baran, S., Weltzin, T. & Kaye, W. (1995). Low discharge weight and outcome in anorexia nervosa. American Journal of Psychiatry, 152, 1070–2.Google Scholar
Beumont, P. J. V., Russell, J. D. & Touyz, S. (1993). Treatment of anorexia nervosa. Lancet, 341, 1635–40.Google Scholar
Brinch, M., Isager, T. & Tolstrup, K. (1988). Patients' evaluation of their former treatment for anorexia nervosa (AN). Nordisk psychkatrisk tidsskrift. Nordic Journal of Psychiatry, 42, 445–8.Google Scholar
Buston, K. (2002). Adolescents with mental health problems: what do they say about health services? Journal of Adolescence, 25, 231–42.Google Scholar
Byford, S., Barrett, B., Roberts, C.et al. (2007). Economic Evaluation of a randomized controlled trial for adolescent anorexia nervosa – the TOuCAN trial. British Journal of Psychiatry, in press.Google Scholar
Crisp, A. H., Norton, K., Gowers, S.et al. (1991). A controlled study of the effect of therapies aimed at adolescent and family psychopathology in anorexia nervosa. British Journal of Psychiatry, 159, 325–33.Google Scholar
Crisp, A. H., Callender, J. S., Halek, C. & Hsu, L. K. G. (1992). Long-term mortality in anorexia nervosa: a 20-year follow-up of the St. George's and Aberdeen cohorts. British Journal of Psychiatry, 161, 104–7.Google Scholar
Grave, Dalle R., Ricca, V. & Todesco, T. (2001). The stepped-care approach in anorexia nervosa and bulimia nervosa: progress and problems. Eating Weight Disorders, 6, 81–9.Google Scholar
Dancyger, I., Fornari, V., Schneider, M.et al. (2003). Adolescents and eating disorders: an examination of a day treatment program. Eating and Weight Disorders, 8, 242–8.Google Scholar
Dare, C. & Eisler, I. (2000). A multi-family group day treatment programme for adolescent eating disorder. European Eating Disorders Review, 8, 4–18.Google Scholar
Eckert, E. D., Goldberg, S. C., Halmi, K. A., Casper, R. C. & Davis, J. M (1979). Behaviour therapy in anorexia nervosa. British Journal of Psychiatry, 134, 55–9.Google Scholar
Eisler, I., Dare, C., Russell, G. F. M., Szmukler, G. I., Grange, D. & Dodge, E. (1997). Family and individual therapy in anorexia nervosa. A 5-year follow-up. Archives of General Psychiatry, 54, 1025–30.Google Scholar
Eisler, I., Le Grange, D. & Asen, E. (2003). Family Interventions. Handbook of Eating Disorders. 2nd edn, ed. Treasure, J., Schmidt, U., & Furth, E., pp. 291–310. Chichester, UK: John Wiley & Sons.
Fairburn, C. (1981). A cognitive behavioural approach to the treatment of bulimia. Psychological Medicine, 11, 707–11.Google Scholar
Franzen, U., Backmund, H. & Gerlinghoff, M. (2004). Day treatment group programme for eating disorders: reasons for drop-out. European Eating Disorders Review, 12, 153–8.Google Scholar
Freeman, C. (1992). Day patient treatment of anorexia nervosa. British Review of Bulimia and Anorexia Nervosa, 6, 3–8.Google Scholar
Garner, D. M. & Needleman, L. D. (1997). Sequencing and integration of treatments. In Handbook of Treatment of Eating Disorders, ed. Garner, D. M. and Garfinkel, P. E., pp. 50–66. New York: Guilford Press.
Gerlinghoff, M., Backmund, H. & Franzen, U. (1998). Evaluation of a day treatment programme for eating disorders. European Eating Disorders Review, 6, 96–106.Google Scholar
Goldfarb, L. A., Fuhr, R., Tsujimoto, R. N. & Fischman, S. E. (1987). Systematic desensitisation and relaxation as adjuncts in the treatment of anorexia nervosa: a preliminary study. Psychological Reports, 60, 411–518.Google Scholar
Gowers, S. G., Clark, A., Roberts, C.et al. Clinical outcomes of treatments for anorexia nervosa: randomized controlled trial – the TOuCAN trial. British Journal of Psychiatry, in press.
Gowers, S., Norton, K., Halek, C. & Crisp, A. H. (1994). Outcome of outpatient psychotherapy in a random allocation treatment study of anorexia nervosa. International Journal of Eating Disorders, 15, 65–77.Google Scholar
Gowers, S. G., Weetman, J., Shore, A., Hossain, F. & Elvins, R. (2000). Impact of hospitalisation on the outcome of adolescent anorexia nervosa. British Journal of Psychiatry, 176, 138–41.Google Scholar
Guarda, A. S. & Heinberg, L. J. (2004). Inpatient and partial hospital approaches to the treatment of eating disorders. In Handbook of Eating Disorders and Obesity, ed. Thompson, J. K., pp. 297–320. New Jersey: John Wiley & Sons, Inc.
Herzog, T., Hartmann, A. & Falk, C. (1996). Total symptom-oriented and psychodynamic concept in inpatient treatment of anorexia nervosa. A quasi-experimental comparative study of 40 admission episodes. Psychotherapie Psychosomatische Medizin und Psychologie, 46, 11–22.Google Scholar
Howard, W. T., Evans, K. K., Quintero-Howard, C. V., Bowers, W. A. & Andersen, A. E. (1999). Predictors of success or failure of transition to day hospital treatment for inpatients with anorexia nervosa. American Journal of Psychiatry, 156, 1697–702.Google Scholar
Jäger, B., Liedke, R., Künsebeck, H.-W., Lempa, W., Kersting, A. & Seide, L. (1996). Psychotherapy and bulimia nervosa: evaluation and long-term follow-up of two conflict-orientated treatment conditions. Acta Psychiatrica Scandinavica, 93, 268–78.Google Scholar
Kahn, C. & Pike, K. (2001). In search of predictors of dropout from inpatient treatment for anorexia nervosa. International Journal of Eating Disorders, 30, 237–44.Google Scholar
Kächele, H. for the study group MZ-ESS (1999). Eine multizentrische Studie zu Aufwand und Erfolg bei psychodynamischer Therapie von Eßstörungen. Psychotherapie und Medizinische Psychologie, 49, 100–8.Google Scholar
Kächele, H., Kordy, H., Richard, M. & Research Group TR-EAT. (2001). Therapy amount and outcome of inpatient psychodynamic treatment of eating disorders in Germany: data from a multicenter study. Psychotherapy Research, 11, 239–57.Google Scholar
Krauth, C. (2002). How high are the costs of eating disorders – anorexia nervosa and bulimia nervosa – for German Society? European Journal of Health Economics, 3, 244–50.Google Scholar
Lacey, J. H. (1995). In-patient treatment of multi-impulsive bulimia nervosa. In Eating Disorders and Obesity, ed. Brownell, K. D. & Fairburn, C. G.. New York: Guilford Press.
Grange, D., Eisler, I., Dare, C. & Russell, G. F. M. (1992). Evaluation of family therapy in anorexia nervosa: a pilot study. International Journal of Eating Disorders, 12, 347–57.Google Scholar
Maddocks, S. E., Kaplan, A. S., Woodside, D. B., Langdon, L. & Piran, N. (1992). Two year follow-up of bulimia nervosa: the importance of abstinence as the criterion of outcome. International Journal of Eating Disorders, 12, 133–41.Google Scholar
Maguire, S., Surgenor, L. J., Abraham, S. and Beumont, P. (2003). An international collaborative database: its use in predicting length of stay for inpatient treatment of anorexia nervosa. Australian and New Zealand Journal of Psychiatry, 37, 741–7.Google Scholar
Meads, C., Gold, L., Burls, A. & Jobanputra, P. (1999). In-patient versus out-patient care for eating disorders. Department of Public Health and Epidemiology. West Midlands Development and Evaluation Service. Report No 17. Birmingham: University of Birmingham.
National Collaborating Centre for Mental Health (2004). Eating disorders. Core interventions in the treatment and management of anorexia nervosa, bulimia nervosa and related eating disorders. London: National Institute for Clinical Excellence.
O'Herlihy, A., Worrall, A., Lelliott, P., Jaffa, T., Hill, P. & Banerjee, S. (2003). Distribution and charactiersitics of in-patient child and adolescent mental health services in England and Wales. British Journal of Psychiatry, 183, 847–551.Google Scholar
Okamoto, A., Yamashita, T., Nagoshi, Y.et al. (2002). A behavior therapy program combined with liquid nutrition designed for anorexia nervosa. Psychiatry and Clinical Neuroscience, 56, 515–20.Google Scholar
Olmsted, M. P., Kaplan, A. S., Rockert, W. & Jacobsen, M. (1996). Rapid responders to intensive treatment of bulimia nervosa. International Journal of Eating Disorders, 19, 279–85.Google Scholar
Olmsted, M. P., Kaplan, A. S. & Rockert, W. (2003). Relative efficacy of a 4-day versus a 5-day day hospital program. International Journal of Eating Disorders, 34, 441–9.Google Scholar
Pillay, M. & Crisp, A. H. (1981). The impact of social skills training within an established inpatient treatment program for anorexia nervosa. British Journal of Psychiatry, 139, 533–9.Google Scholar
Rathner, G. & Rainer, B. (1997). Annual treatment rates and estimated prevalence of eating disorders in Austria. Wiener Klinische Wochenschrift, 109, 275–80.Google Scholar
Rosenvinge, J. H. & Klusmeier, A. K. (2000). Treatment for eating disorders from a patient satisfaction perspective: a Norwegian replication of a British study. European Eating Disorders Review, 8, 293–300.Google Scholar
Royal Australian and New Zealand College of Psychiatrists Clinical Practice Guidelines Team for Anroexia nervosa. (2004). Australian and New Zealand clinical practice guidelines for the treatment of anorexia nervosa. Australian and New Zealand Journal of Psychiatry, 38, 659–70.
Royal College of Psychiatrists (1992). Eating disorders (Council Report 14). London: Royal College of Psychiatrists.
Schmidt, U. (1989). Behavioural psychotherapy for eating disorders. International Review Journal of Psychiatry, 1, 245–56.Google Scholar
Solanto, M. V., Jacobson, M. S., Heller, L., Golden, N. H. & Hertz, S. (1994). Rate of weight gain of inpatients with anorexia nervosa under two behavioral contracts. Pediatrics, 93, 989–91.Google Scholar
Striegel-Moore, R. H., Leslie, D., Petrill, S. A., Garvin, V. & Rosenheck, R. A. (2000). One-year use and cost of inpatient and outpatient services among female and male patients with an eating disorder: evidence from a national database of health insurance claims. International Journal of Eating Disorders, 27, 381–9.Google Scholar
Tasca, G. A., Flynn, C. & Bissada, H. (2002). Comparison of group climate in an eating disorders partial hospital group and a psychiatric partial hospital group. International Journal of Group Psychotherapy, 52, 409–17.Google Scholar
Thompson, A., Shaw, M., Harrison, G., Verne, J., Ho, D. & Gunnell, D. (2004). Patterns of hospital admission for adult psychiatric illness in England: analysis of Hospital Episode Statistics data. British Journal of Psychiatry, 185, 334–41.Google Scholar
Thornton, C., Beaumont, P. & Touyz, S. (2002). The Australian experience of day programs for patients with eating disorders. International Journal of Eating Disorders, 32, 1–10.Google Scholar
Touyz, S. W., Beumont, P. J., Glaun, D., Phillips, T. & Cowie, I. (1984). A comparison of lenient and strict operant conditioning programs in refeeding patients with anorexia nervosa. British Journal of Psychiatry, 144, 517–20.Google Scholar
Touyz, S. W., Lennerts, W., Freeman, R. J. & Beumont, P. J. (1990). To weigh or not to weigh? Frequency of weighing and rate of weight gain in patients with anorexia nervosa. British Journal of Psychiatry, 157, 752–4.Google Scholar
Touyz, S., Thornton, C., Rieger, E., George, L. & Beaumont, P. (2003). The incorporation of the stage of change model in the day hospital treatment of patients with anorexia nervosa. European Child and Adolescent Psychiatry, 12, 65–71.Google Scholar
Treasure, J. & Schmidt, U. (2004). Anorexia nervosa. Clinical Evidence, 12, 1192–203.Google Scholar
Vandereycken, W. (1985). Inpatient treatment of anorexia nervosa: some research-guided changes. Journal of Psychiatric Research, 19, 2–3, 413–22.Google Scholar
Vandereycken, W. (2003). The place of inpatient care in the treatment of anorexia nervosa: questions to be answered. International Journal of Eating Disorders, 34, 409–22.Google Scholar
Weizman, A., Tyano, S., Wijsenbeek, H. & David, Ben M. (1985). Behavior therapy, pimozide treatment and prolactin secretion in anorexia nervosa. Psychotherapy and Psychosomatics, 43, 136–40.Google Scholar
Williamson, D. A., Thaw, J. M. & Varnado-Sullivan, P. J. (2001). Cost-effectiveness analysis of a hospital-based cognitive-behavioral treatment program for eating disorders. Behavior Therapy, 32, 459–77.Google Scholar
Winston, A. & Webster, P. (2003). Inpatient treatment. In Handbook of Eating Disorders. 2nd edn, ed. Treasure, J., Schmidt, U. & Furth, E.. Chichester, UK: John Wiley & Sons.
Wiseman, C. V., Sunday, S. R., Klapper, F., Harris, W. A. & Halmi, K. A. (2001). Changing patterns of hospitalization in eating disorder patients. International Journal of Eating Disorders, 30, 69–74.Google Scholar
Woodside, D. B. & Kaplan, A. S. (1994). Day hospital treatment in males with eating disorders – response and comparison to females. Journal of Psychosomatic Research, 38, 471–5.Google Scholar
Wullemier, F., Rossel, F. & Sinclair, K. (1975). La therapie comportementale de l'anorexie nerveuse. Journal of Psychosomatic Research, 19, 267–72.Google Scholar
Zeeck, A., Herzog, T. & Hartmann, A. (2004). Day clinic or inpatient care for severe bulimia nervosa? European Eating Disorders Review, 12, 79–86.Google Scholar
Zipfel, S., Reas, D. L., Thornton, C.et al. (2002). Day hospitalization programs for eating disorders: a systematic review of the literature. International Journal of Eating Disorders, 31, 105–17.Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

  • Complex treatments for eating disorders
    • By Scott Crow, Department of Psychiatry University of Minnesota Medical School Minneapolis, MN USA, Ulrike Schmidt, Institute of Psychiatry De Crespigny Park London UK
  • Edited by Peter Tyrer, Imperial College of Science, Technology and Medicine, London, Kenneth R. Silk, University of Michigan, Ann Arbor
  • Book: Cambridge Textbook of Effective Treatments in Psychiatry
  • Online publication: 12 May 2010
  • Chapter DOI: https://doi.org/10.1017/CBO9780511544392.044
Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

  • Complex treatments for eating disorders
    • By Scott Crow, Department of Psychiatry University of Minnesota Medical School Minneapolis, MN USA, Ulrike Schmidt, Institute of Psychiatry De Crespigny Park London UK
  • Edited by Peter Tyrer, Imperial College of Science, Technology and Medicine, London, Kenneth R. Silk, University of Michigan, Ann Arbor
  • Book: Cambridge Textbook of Effective Treatments in Psychiatry
  • Online publication: 12 May 2010
  • Chapter DOI: https://doi.org/10.1017/CBO9780511544392.044
Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

  • Complex treatments for eating disorders
    • By Scott Crow, Department of Psychiatry University of Minnesota Medical School Minneapolis, MN USA, Ulrike Schmidt, Institute of Psychiatry De Crespigny Park London UK
  • Edited by Peter Tyrer, Imperial College of Science, Technology and Medicine, London, Kenneth R. Silk, University of Michigan, Ann Arbor
  • Book: Cambridge Textbook of Effective Treatments in Psychiatry
  • Online publication: 12 May 2010
  • Chapter DOI: https://doi.org/10.1017/CBO9780511544392.044
Available formats
×