Modifications and problems of behavioural inpatient management of anorexia nervosa: A “patient‐suited” approach?

ABSTRACT— Several treatment modalities, especially behaviour therapy, had been successfully administered in order to normalize body weight in anorexia nervosa inpatients. However, improvement in affective, cognitive and psychosocial features and associated psychopathologic symptoms was rather poor. It is hypothesized that the limited effect of behaviour therapy may be also due to therapeutic shortcomings of the behavioural treatment programme. In the present study of 16 anorectic inpatients a behavioural treatment programme, which had been applied in a former investigation at the same unit, was modified and yielded the following results: rapid increase in weight, good improvement of anorectic and depressive symptoms and a treatment duration of less than 3 months. Although the short‐term outcome of the modified treatment programme is encouraging, the therapeutic difficulties encountered in this programme deserve special attention and its long‐term effects on the course and prognosis of anorexia nervosa have to be established.

[1]  K. Halmi Anorexia nervosa: A clinician's guide to treatment, Walter Van derEycken, Rolf Meermann. de Gruyter, Berlin, New York (1984), 251, DM 98 , 1986 .

[2]  Patricia J Schroder,et al.  HANDBOOK OF PSYCHOTHERAPY FOR ANOREXIA NERVOSA AND BULIMIA , 1986 .

[3]  C. Salmond,et al.  Anorexia nervosa: long-term outcome in 50 female patients. , 1985, The British journal of psychiatry : the journal of mental science.

[4]  H. Kraemer,et al.  The treatment of anorexia nervosa: do different treatments have different outcomes? , 1983, Research publications - Association for Research in Nervous and Mental Disease.

[5]  H. Morgan,et al.  Management and Outcome in Anorexia Nervosa , 1983, British Journal of Psychiatry.

[6]  R. Pierloot,et al.  Drop-out during in-patient treatment of anorexia nervosa: a clinical study of 133 patients. , 1983, The British journal of medical psychology.

[7]  K. Pirke,et al.  Behavior, attitude, nutrition and endocrinology in anorexia nervosa: A LONGITUDINAL STUDY IN 24 PATIENTS , 1982, Acta psychiatrica Scandinavica.

[8]  J. Katz,et al.  Anorexia nervosa and bulimia. , 1982, Archives of general psychiatry.

[9]  D. Schwartz,et al.  Do anorectics get well? Current research and future needs. , 1981, The American journal of psychiatry.

[10]  L. Hsu Outcome of anorexia nervosa. A review of the literature (1954 to 1978). , 1980, Archives of general psychiatry.

[11]  H. Bruch Perils of behavior modification in treatment of anorexia nervosa. , 1974, JAMA.

[12]  S. Bhanji,et al.  Operant Conditioning in the Treatment of Anorexia Nervosa: A Review and Retrospective Study of 11 Cases , 1974, British Journal of Psychiatry.

[13]  D. Zerssen Clinical Self-Rating Scales (CSRS) of the Munich Psychiatric Information System (PSYCHIS München) , 1986 .

[14]  P. Powers Anorexia Nervosa: A Multidimensional Perspective , 1984 .

[15]  R. J. Daitzman Diagnosis and intervention in behavior therapy and behavioral medicine , 1983 .

[16]  W. Agras,et al.  Behaviour therapy in anorexia nervosa: A data-based approach to the question , 1978 .

[17]  K. Halmi,et al.  Treatment of anorexia nervosa with behavior modification. Effectiveness of formula feeding and isolation. , 1975, Archives of general psychiatry.

[18]  J. Feighner,et al.  Diagnostic criteria for use in psychiatric research. , 1972, Archives of general psychiatry.