Depression, worry, and psychosocial functioning predict eating disorder treatment outcomes in a residential and partial hospitalization setting
- 291 Downloads
This retrospective study explores depression, worry, psychosocial functioning, and change in body mass index (BMI) as predictors of eating disorder (ED) symptomatology and BMI at discharge and 1-year follow-up from a residential and partial hospitalization ED treatment center. Participants were 423 male and female patients receiving treatment at an ED treatment center. Results indicate significant improvement in ED symptomatology, psychological impairment, and change in BMI (in patients with anorexia nervosa) at treatment discharge and follow-up compared to treatment admission (ps < 0.001). Depression and worry predicted ED symptomatology and psychological impairment at discharge (ps < 0.05). Depression, worry, and psychosocial functioning predicted ED symptomatology and psychological impairment at 1-year follow-up (ps < 0.001). Change in BMI was not a significant predictor of outcome. Depression, worry, and psychosocial functioning each play a role in treatment outcomes and may help clarify who might benefit from treatment. Clinicians in ED treatment centers should consider these as areas of focus for improved outcomes.
KeywordsEating disorder Predictor Treatment outcome Depression Anxiety Worry
The authors would like to thank Kim McCallum for her assistance with this research.
Compliance with ethical standards
Conflict of interest
LF was an employee and LS was the Chief Executive Officer of the eating disorder clinic where data were collected in the present study.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This retrospective study was approved by the Institutional Review Board at Washington University in St. Louis.
We submitted an IRB for this study to Washington University in St. Louis and the IRB deemed this study to not need IRB approval due to its retroactive nature.
- 6.Herpetz-Dalmann B, Hebebrand J, Müller B, Herpetz S, Heussen N, Remschmidt H (2001) Prospective 10-year follow-up in adolescent anorexia nervosa—Course, outcome, psychiatric comorbidity, and psychosocial adaptation. J Child Psychol Psyc 42:603–612. doi: 10.1111/1469-7610.00756 CrossRefGoogle Scholar
- 24.Fichter MM, Quadflieg N (1999) Six-year course and outcome of anorexia nervosa. Int J Eat Disord 26:359–385. doi: 10.1002/(SICI)1098-108X(199912)26:4<359::AID-EAT2>3.0.CO;2-7 PubMedCrossRefGoogle Scholar
- 28.Rossiter EM, Agras WS, Telch CF, Schneider JA (1993) Cluster B personality disorder characteristics predict outcome in the treatment of bulimia nervosa. Int J Eat Disord 13:349–357. doi: 10.1002/1098-108X(199305)13:4<349::AID-EAT2260130403>3.0.CO;2-C PubMedCrossRefGoogle Scholar
- 32.Kerkhof A, Hermas D, Figee A, Laeremans I, Pieters G, Aardema A (2000) The Penn State Worry Questionnaire and the Worry Domains Questionnaire: first results in Dutch and Flemish in-and outpatient groups. Gedragstherapie 33:135–145Google Scholar
- 36.Fairburn CG (2008) Cognitive behavior therapy and eating disorders. The Guilford Press, New YorkGoogle Scholar
- 38.Beck AT, Steer RA, Brown GK (1996) Manual for the Beck Depression Inventory-II. Psychological Corporation, San AntonioGoogle Scholar
- 40.Ustün TB, Kostanjsek N, Chatterji S, Rehm J (eds) (2010) Measuring health and disability: Manual for WHO Disability Assessment Schedule (WHODAS 2.0). World Health Organization, GenevaGoogle Scholar
- 41.Luce KH, Crowther JH (1999) The reliability of the Eating Disorder Examination Self-Report Questionnaire Version (EDE-Q). Int J Eat Disord 25:349–351. doi: 10.1002/(SICI)1098-108X(199904)25:3<349::AID-EAT15>3.0.CO;2-M PubMedCrossRefGoogle Scholar
- 46.Adult BMI Calculator (n.d.). In Centers for Disease Control and Prevention online. http://www.cdc.gov/healthyweight/assessing/bmi/adult_bmi/english_bmi_calculator/bmi_calculator.html. Accessed 20 May 2016.
- 47.Honaker J, King G, Blackwell M. AMELIA II: A program for missing data (2015). Retrieved from https://cran.r-project.org/web/packages/Amelia/vignettes/amelia.pdf
- 48.Beck AT, Emery G, Greenberg RL (2005) Anxiety disorders and phobias: a cognitive perspective. Basic Books, CambridgeGoogle Scholar
- 49.Lewinsohn PM, Biglan A, Zeiss AS (1976) Behavioral treatment of depression. In: Davidson PO (ed) The behavioral management of anxiety, depression and pain. Brunner/Mazel, New York, pp 91–146Google Scholar
- 51.Vall E, Wade TD (2016) Predictors and moderators of outcomes and readmission for adolescent inpatients with anorexia nervosa: a pilot study. Clin Psych. doi: 10.1111/cp.12091 (in press)