Serrano-Troncoso Eduardo, Fàbrega-Ribera Marina, Coll-Pla Núria, Godrid-García Mónica, Carulla-Roig Marta, Cecilia-Costa Raquel, Soto-Usera Pau, Sánchez-Fernández Bernardo, Matalí-Costa Josep, Dolz-Abadia Montserrat
Child and Adolescent Psychiatry and Psychology Department, Hospital Sant Joan de Déu of Barcelona, Spain Children and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Barcelona, Spain.
Child and Adolescent Psychiatry and Psychology Department, Hospital Sant Joan de Déu of Barcelona, Spain.
Actas Esp Psiquiatr. 2020 Jan;48(1):19-27. Epub 2020 Jan 1.
Inpatient Treatment (IT) is the treatment of choice for moderate or severely ill adolescents with Anorexia Nervosa (AN). Nevertheless, it is expensive, and the risk for relapse or readmissions is high. A less costly alternative to IT is Day Patient Treatment (DP), which may also help to avoid relapses and readmissions because facilitates transition from hospital to community treatment.
To assess the effectiveness of the 11-hour DP program for Eating Disorders (DP-ED-11h), a new intensive DP treatment for adolescents with AN, with respect to weight recovery, avoidance of hospital admission and decrease of Length of Stay (LoS).
A longitudinal, naturalistic study was carried out analysing clinical and sociodemographic variables from 77 patients with AN who were consecutively discharged from DP-ED-11h, during years 2015-2016.
There were 77 discharges. The average age was 14.4 years old (SD: 1.62). The LoS at DP-ED-11h was 28.9 days (SD: 18.5). The mean body mass index increased significantly at discharge (17.2 vs. 17.9, p<0.001) and at 12 months follow- up (17.9 vs. 19.3, p<0.001). Twenty nine (70.8%) of the patients treated at DP-ED-11h, who came from a less intensive setting, avoided an admission. Fourteen (18.2%) required readmission at DP-ED-11h within two years. The LoS at IT was significantly reduced (from 33 to 24 days, p<0.043).
DP-ED-11h has shown to be an effective resource as an alternative to IT for adolescents with moderate to severe AN. This new model has cost-effectiveness implications as it is a safe resource and is less costly than IT.
住院治疗（IT）是中度或重度神经性厌食症（AN）青少年患者的首选治疗方法。然而，其费用高昂，且复发或再次入院的风险很高。日间患者治疗（DP）是一种成本较低的替代方案，它也可能有助于避免复发和再次入院，因为它便于从医院治疗过渡到社区治疗。
评估针对饮食失调的11小时日间患者治疗方案（DP-ED-11h）——一种针对患有神经性厌食症的青少年的新型强化日间患者治疗方案——在体重恢复、避免住院以及缩短住院时长（LoS）方面的有效性。
开展了一项纵向、自然主义研究，分析了2015年至2016年期间连续从DP-ED-11h出院的77例神经性厌食症患者的临床和社会人口统计学变量。
共有77例患者出院。平均年龄为14.4岁（标准差：1.62）。在DP-ED-11h的住院时长为28.9天（标准差：18.5）。出院时平均体重指数显著增加（17.2对17.9，p<0.001），在12个月随访时也显著增加（17.9对19.3，p<0.001）。来自强度较低治疗环境的DP-ED-11h治疗的患者中有29例（70.8%）避免了住院。14例（18.2%）在两年内需要在DP-ED-11h再次入院。住院治疗的住院时长显著缩短（从33天降至24天，p<0.043）。
对于中度至重度神经性厌食症的青少年，DP-ED-11h已被证明是一种有效的替代住院治疗的方案。这种新模式具有成本效益，因为它是一种安全的方案，且成本低于住院治疗。
