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住院治疗饮食失调的提前终止:时机重要吗?

Premature termination of inpatient eating disorder treatment: Does timing matter?

作者信息

Smith Sarah, Sutandar Kalam, Woodside Blake

机构信息

Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada.

Department of Psychiatry, University of Toronto, 25 Sheppard Ave West, Suite 300, Toronto, ON, M2N 6S6, Canada.

出版信息

J Eat Disord. 2023 Nov 27;11(1):210. doi: 10.1186/s40337-023-00934-5.

Abstract

BACKGROUND

Premature termination of treatment is a serious problem in the treatment of eating disorders. Prior research attempting to differentiate patients who are able to complete treatment from those who terminate early has yielded mixed results. One proposed explanation for this is a failure to examine the time course of treatment termination. This study was designed to explore associations between baseline patient characteristics and timing of treatment termination.

METHODS

Participants were 124 eating disorder patients admitted voluntarily to the inpatient program at Toronto General Hospital between 2009 and 2015. At admission, all patients completed measures of eating disorder symptoms, eating disorder cognitions, depressive symptoms and emotional dysregulation. Body weight was measured weekly. Data analyses were completed using one-way ANOVAs and Chi Square tests.

RESULTS

Results showed significant associations between timing of treatment termination and eating disorder diagnosis, severity of eating disorder cognitions and severity of depressive symptoms. Post-hoc analyses revealed that patients who left treatment early had more severe depressive symptoms, eating disorder cognitions related to eating and difficulties engaging in goal directed behaviors when emotionally dysregulated.

CONCLUSIONS

Patients who terminated inpatient treatment early in their admissions differ from patients who terminated later and those who completed treatment. These differences have potential clinical implications for the clinical management of patients with severe eating disorders requiring inpatient admission. Trial registration This paper is not associated with a clinical trial.

摘要

背景

治疗中断是饮食失调治疗中的一个严重问题。先前试图区分能够完成治疗的患者和提前终止治疗的患者的研究结果不一。对此提出的一种解释是未能考察治疗中断的时间进程。本研究旨在探讨基线患者特征与治疗中断时间之间的关联。

方法

参与者为2009年至2015年间自愿入住多伦多综合医院住院项目的124名饮食失调患者。入院时,所有患者均完成了饮食失调症状、饮食失调认知、抑郁症状和情绪调节障碍的测量。每周测量体重。使用单因素方差分析和卡方检验完成数据分析。

结果

结果显示治疗中断时间与饮食失调诊断、饮食失调认知严重程度和抑郁症状严重程度之间存在显著关联。事后分析显示,提前离开治疗的患者有更严重的抑郁症状、与饮食相关的饮食失调认知以及在情绪失调时难以进行目标导向行为。

结论

入院早期就终止住院治疗的患者与后期终止治疗的患者以及完成治疗的患者不同。这些差异对于需要住院治疗的严重饮食失调患者的临床管理具有潜在的临床意义。试验注册 本文与一项临床试验无关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/23bb/10680217/ab4521d62d04/40337_2023_934_Fig1_HTML.jpg

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