Modifications and problems of behavioural inpatient management of anorexia nervosa: a "patient-suited" approach?

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.