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Subjective evaluation of outpatient treatment for adolescent patients with anorexia nervosa

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Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity Aims and scope Submit manuscript

Abstract

Background

The current study investigates determinants of treatment evaluation by adolescent outpatients with anorexia nervosa (AN) and the accordance with their parents’ and psychotherapists’ evaluation.

Sampling and methods

The sample included 50 female adolescent outpatients (mean age: 16.9 ± 1.8) with AN (DSM-IV). They were randomly assigned to either cognitive-behavior therapy (CBT) or dialectical-behavior therapy (DBT). Before (T1) and after treatment (T2) diagnostic interviews as well as self-report questionnaires were administered measuring eating disorder-specific and general psychopathology. The subjective evaluation of the therapy was assessed by a self-report questionnaire. Data on the evaluation of treatment of 42 parents were considered as well as treatment evaluations of the therapists for 48 patients.

Results

Our results revealed significant correlations of treatment satisfaction between parents and therapists, whereas patients and therapists as well as patients and parents did not agree in their treatment evaluation. The change in body mass index (BMI) was a significant predictor of the patients’ treatment satisfaction.

Conclusion

Adolescent patients displaying high severity of AN at the beginning of treatment put little emphasis on the importance of body weight even after treatment. Satisfaction ratings of this special group of patients could be heavily distorted and have to be interpreted carefully.

Level of evidence

Level I, randomized controlled trial.

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References

  1. Sackett D, Strauss S, Richardson S, Rosenberg W, Haynes BR (2000) Evidence-based medicine: how to practice and teach EBM. Churchill Livingstone, Edinburgh

    Google Scholar 

  2. Newton T (2001) Consumer involvement in the appraisal of treatments for people with eating disorders: a neglected area of research? Eur Eat Disord Rev 9:301–308. https://doi.org/10.1002/erv.435

    Article  Google Scholar 

  3. de la Rie S, Noordenbos G, Donker M, van Furth E (2008) The quality of treatment of eating disorders: a comparison of the therapists’ and the patients’ perspective. Int J Eat Disord 41:307–317. https://doi.org/10.1002/eat.20494

    Article  PubMed  Google Scholar 

  4. Bell L (2003) What can we learn from consumer studies and qualitative research in the treatment of eating disorders? Eat Weight Disord Stud Anorex Bulim Obes 8:181–187. https://doi.org/10.1007/BF03325011

    Article  CAS  Google Scholar 

  5. de la Rie S, Noordenbos G, Donker M, van Furth E (2006) Evaluating the treatment of eating disorders from the patient’s perspective. Int J Eat Disord 39:667–676. https://doi.org/10.1002/eat.20317

    Article  PubMed  Google Scholar 

  6. Klinkowski N, Korte A, Lehmkuhl U, Pfeiffer E, Salbach H (2007) Dialektisch-Behaviorale Therapie für jugendliche Patientinnen mit Anorexia und Bulimia nervosa (DBT-AN/BN)—eine Pilotstudie. Prax Kinderpsychol Kinderpsychiatr 56:91–108. https://doi.org/10.13109/prkk.2007.56.2.91

    Article  PubMed  Google Scholar 

  7. Kopec-Schrader EM, Marden K, Rey JM, Touyz SW, Beumont PJV (1993) Parental evaluation of treatment outcome and satisfaction with an inpatient program for eating disorders. Aust N Z J Psychiatry 27:264–269. https://doi.org/10.1080/00048679309075775

    Article  CAS  PubMed  Google Scholar 

  8. Schneider N, Korte A, Lenz K, Pfeiffer E, Lehmkuhl U, Salbach-Andrae H (2010) Subjective evaluation of DBT treatment by adolescent patients with eating disorders and the correlation with evaluations by their parents and psychotherapists. Z Kinder Jugendpsychiatr Psychother 38:51–57. https://doi.org/10.1024/1422-4917.a000006

    Article  PubMed  Google Scholar 

  9. Singh S, Accurso EC, Hail L, Goldschmidt AB, Grange DL (2018) Outcome parameters associated with perceived helpfulness of family-based treatment for adolescent eating disorders. Int J Eat Disord 51:574–578. https://doi.org/10.1002/eat.22863

    Article  PubMed  Google Scholar 

  10. Salbach-Andrae H, Bohnekamp I, Bierbaum T, Schneider N, Thurn C, Stiglmayr C, Lenz K, Pfeiffer E, Lehmkuhl U (2009) Dialektisch behaviorale therapie (DBT) und kognitiv behaviorale therapie (CBT) für Jugendliche mit Anorexia und Bulimia nervosa im Vergleich. Kindh Entwickl 18:180–190. https://doi.org/10.1026/0942-5403.18.3.180

    Article  Google Scholar 

  11. Weiß RH (2016) Grundintelligenztest Skala 2—revision (CFT 20-R) mit Wortschatztest und Zahlenfolgentest—Revision (WS/ZF-R). Hogrefe, Göttingen

    Google Scholar 

  12. American Psychiatric Association (1994) Diagnostic and statistical manual of mental disorders: DSM-IV. American Psychiatric Association, Washington

    Google Scholar 

  13. Fichter M, Quadflieg N (2001) The structured interview for anorexic and bulimic disorders for DSM-IV and ICD-10 (SIAB-EX): reliability and validity. Eur Psychiatry 16:38–48. https://doi.org/10.1016/S0924-9338(00)00534-4

    Article  CAS  PubMed  Google Scholar 

  14. Wittchen H-U, Pfister H (1996) DIA-X-diagnostisches expertensystem für ICD-10 und DSM-IV. Swets, Frankfurt

    Google Scholar 

  15. Jacobi C, Thiel A, Paul T (2000) Kognitive Verhaltenstherapie bei Anorexia und Bulimia nervosa. Beltz, Weinheim

    Google Scholar 

  16. Salbach-Andrae H, Jacobi C, Jaite C (2010) Anorexia und Bulimia nervosa im Jugendalter. Kognitiv-verhaltenstherapeutisches Behandlungsmanual. Beltz, Weinheim

    Google Scholar 

  17. Linehan MM (1993) Cognitive-behavioral treatment of borderline personality disorder. Guilford, New York

    Google Scholar 

  18. Ritschel LA, Lim NE, Stewart LM (2015) Transdiagnostic applications of DBT for adolescents and adults. Am J Psychother 69:111–128. https://doi.org/10.1176/appi.psychotherapy.2015.69.2.111

    Article  PubMed  Google Scholar 

  19. Paul T, Thiel A (2004) Eating disorder inventory-2 (EDI-2). Hogrefe, Göttingen

    Google Scholar 

  20. Franke GH (2002) Symptom-checkliste (SCL-90-R). Hogrefe, Göttingen

    Google Scholar 

  21. Mattejat F, Remschmidt H (1998) Fragebögen zur Beurteilung der Behandlung (FBB). Hogrefe, Göttingen

    Google Scholar 

  22. Rathner G, Waldherr K (1997) Eine deutschsprachige Validierung mit Normen für weibliche und männliche Jugendliche [Eating disorder inventory-2: a German language validation with norms for female and male adolescents]. Z Für Klin Psychol Psychiatr Psychother 45(2):157–182

    Google Scholar 

  23. Cohen J (1988) Statistical power analysis for the behavioral sciences, 2th edn. Erlbaum, Hillsdale

    Google Scholar 

  24. Serpell L, Treasure J, Teasdale J, Sullivan V (1999) Anorexia nervosa: friend or foe? Int J Eat Disord 25:177–186 https://doi.org/10.1002/(SICI)1098-108X(199903)25:2%3C177::AID-EAT7%3E3.0.CO;2-D

    Article  CAS  PubMed  Google Scholar 

  25. Abbate-Daga G, Amianto F, Delsedime N, De-Bacco C, Fassino S (2013) Resistance to treatment and change in anorexia nervosa: a clinical overview. BMC Psychiatry 13:294. https://doi.org/10.1186/1471-244X-13-294

    Article  PubMed  PubMed Central  Google Scholar 

  26. Hillen S, Dempfle A, Seitz J, Herpertz-Dahlmann B, Bühren K (2015) Motivation to change and perceptions of the admission process with respect to outcome in adolescent anorexia nervosa. BMC Psychiatry 15:140. https://doi.org/10.1186/s12888-015-0516-8

    Article  PubMed  PubMed Central  Google Scholar 

  27. Mander J, Teufel M, Keifenheim K, Zipfel S, Giel KE (2013) Stages of change, treatment outcome and therapeutic alliance in adult inpatients with chronic anorexia nervosa. BMC Psychiatry 13:111. https://doi.org/10.1186/1471-244X-13-111

    Article  PubMed  PubMed Central  Google Scholar 

  28. Hay PJ, Touyz S, Sud R (2012) Treatment for severe and enduring anorexia nervosa: a review. Aust N Z J Psychiatry 46:1136–1144. https://doi.org/10.1177/0004867412450469

    Article  PubMed  Google Scholar 

  29. Hay P, Touyz S (2015) Treatment of patients with severe and enduring eating disorders. Curr Opin Psychiatry 28:473–477. https://doi.org/10.1097/YCO.0000000000000191

    Article  PubMed  Google Scholar 

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Acknowledgements

This project was supported by the Stiftung RTL–Wir helfen Kindern e.V. The authors wish to thank the adolescents and their families who participated in the project.

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Author notes

  1. Charlotte Jaite and Antje Pfeiffer contributed equally to the manuscript.

Authors and Affiliations

  1. Department of Child and Adolescent Psychiatry, Charité-Universitätsmedizin Berlin, Berlin, Germany

    Charlotte Jaite, Antje Pfeiffer, Ernst Pfeiffer, Tobias Bierbaum, Sibylle Maria Winter & Ulrike Lehmkuhl

  2. Center for Chronic Sick Children, Charité-Universitätsmedizin Berlin, Berlin, Germany

    Claudia Thurn

  3. Department of Clinical Psychology, Freie Universität Berlin, Berlin, Germany

    Harriet Salbach

Authors
  1. Charlotte Jaite
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  2. Antje Pfeiffer
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Corresponding author

Correspondence to Charlotte Jaite.

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Conflict of interest

All authors declared no conflicting interests.

Ethical approval

All procedures performed in this study were in accordance with the ethical standards of the university’s Institutional Review Board and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The study was approved by the Institutional Review Board.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Jaite, C., Pfeiffer, A., Pfeiffer, E. et al. Subjective evaluation of outpatient treatment for adolescent patients with anorexia nervosa. Eat Weight Disord 25, 445–452 (2020). https://doi.org/10.1007/s40519-018-0620-0

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  • DOI: https://doi.org/10.1007/s40519-018-0620-0

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