Compliance and outcome in treatment-resistant anorexia and bulimia: A retrospective study

• Published in: British journal of clinical psychology Vol. 40; no. 2; pp. 189 - 195
• Main Authors: Towell, Dawn Baker, Woodford, Sally, Reid, Steven, Rooney, Barbara, Towell, Anthony
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01-06-2001; British Psychological Society
• Subjects: Adolescent; Adult; Adult and adolescent clinical studies; Anorexia; Anorexia nervosa; Anorexia Nervosa - diagnosis; Anorexia Nervosa - epidemiology; Anorexia Nervosa - therapy; Biological and medical sciences; Body Mass Index; Bulimia - diagnosis; Bulimia - epidemiology; Bulimia - therapy; Case reports; Clinical outcomes; Clinical psychology; Compliance; Eating behavior disorders; Eating disorders; Female; Humans; Male; Medical sciences; Medical treatment; Mental health; Mental illness; Middle Aged; Miscellaneous; Patient Admission; Patient Compliance - statistics & numerical data; Patients; Psychology; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Recurrence; Retrospective Studies; Severity of Illness Index; Somatoform Disorders - epidemiology; Time Factors; Treatment; Treatment Outcome; Bulimia; Human; Symptomatology; Body image; Treatment efficiency; Prediction; Evolution; Treatment compliance; Personality; Anorexia nervosa; Eating disorder; Negative therapeutic reaction
• ISSN: 0144-6657; 2044-8260
• DOI: 10.1348/014466501163634

Objectives. To investigate the extent to which compliance with treatment is related to outcome, and factors associated with compliance in a group of treatment‐resistant eating‐disordered in‐patients.
Design. A retrospective case study design was employed where clinic staff made expert ratings of eating behaviours, attitudes and outcome of former in‐patients.
Method. Ten health‐care staff at a specialist eating disorders clinic rated overall success of treatment outcome at discharge, as well as compliance, severity of disordered eating behaviours and body‐image disturbance at both admission and discharge for 46 anorexic and 14 bulimic patients.
Results. For all participants, high compliance at admission was associated with lower levels of body image disturbance, less disordered eating behaviours and higher ratings of overall treatment success at discharge. Compliance at admission predicted the body mass index (BMI) at discharge for anorexic participants and predicted higher ratings of overall treatment success at discharge for all participants. In all participants, compliance at admission was related to the extent of eating‐disordered behaviours at admission.
Conclusions. Results suggest the importance of compliance in facilitating recovery and treatment success among treatment‐resistant eating‐disordered in‐patients. The promotion of strategies to improve compliance in this population should be considered. A role for motivational interviewing is discussed.