Predictors of dropout from inpatient treatment for anorexia nervosa: Data from a large French sample |
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Authors: | Caroline Huas,Nathalie Godart,Christine Foulon,Alexandra Pham-Scottez,Snezana DivacValé rie Fedorowicz,Emilie Peyracque,Roland Dardennes,Bruno Falissard,Fré dé ric Rouillon |
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Affiliation: | a Inserm, U669, Paris, Franceb Univ Paris-Sud and Univ Paris Descartes, UMR-S0669, Paris, Francec Department of General Practice, Univ Paris 7 Denis-Diderot, Paris F-75870d Institut Mutualiste Montsouris, Paris, Francee AP-HP, Hôpital Sainte-Anne, Clinique des maladies mentales et de l'Encéphale, Paris, Francef AP-HP, Hôpital Paul Brousse, Département de santé publique, Villejuif, France |
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Abstract: | Dropout from anorexia nervosa inpatient treatment programs is frequent and is linked to a poorer outcome. This study aimed to identify predictive factors for dropout among anorexia nervosa inpatients. Between 1988 and 2004, 601 consecutive female inpatients with anorexia, restrictive (AN-R) or binge/purging (AN-B/P) subtype (Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV)), were assessed at admission (clinical, socio-demographic, and psychological data). A stepwise logistic model was developed. Dropout rates were respectively 50.0% and 56.2% for AN-R and AN-B/P. Seven predictive factors were identified in multivariate analysis: having one or more children, low desired body mass index (BMI), a low minimum BMI, high scores on the SCL-90 paranoid ideation and the Morgan and Russell eating behavior subscales, and low educational status. Early dropouts had a particular profile: lower desired BMI, higher score on SCL90 paranoid subscale, and more impulsive behaviors (alcohol use, suicide attempts). Dropout appeared as a multifactorial event. In clinical practice, certain factors could serve as warning messages reflecting the severity of the illness (high EDI score and low minimum BMI); while others could be targeted before hospitalization (having at least one child and low desired BMI). |
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Keywords: | Eating disorders Care Dropout Inpatient treatment Risk factors |
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