Predictors of treatment outcome in higher levels of care among a large sample of adolescents with heterogeneous eating disorders.

Autor:	Reilly EE; Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, USA. Erin.Reilly3@ucsf.edu., Gorrell S; Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, USA., Duffy A; Eating Recovery Center/Pathlight Mood & Anxiety Center, Denver, CO, USA., Blalock DV; Center of Innovation to Accelerate Discovery and Practice Transformation, Durham Veterans Affairs Medical Center, Durham, NC, USA.; Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA., Mehler P; Eating Recovery Center/Pathlight Mood & Anxiety Center, Denver, CO, USA.; Acute Center for Eating Disorders at Denver Health, Denver, CO, USA.; University of Colorado School of Medicine, Denver, CO, USA., Brandt H; Eating Recovery Center/Pathlight Mood & Anxiety Center, Denver, CO, USA., McClanahan S; Eating Recovery Center/Pathlight Mood & Anxiety Center, Denver, CO, USA., Zucker K; Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, USA., Lynch N; Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, USA., Singh S; Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, USA., Drury CR; Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, USA., Grange DL; Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, USA.; Department of Psychiatry & Behavioral Neuroscience, The University of Chicago (Emeritus), Chicago, IL, USA., Rienecke RD; Eating Recovery Center/Pathlight Mood & Anxiety Center, Denver, CO, USA.; Department of Psychiatry and Behavioral Sciences, Northwestern University, Chicago, IL, USA.
Jazyk:	angličtina
Zdroj:	Child and adolescent psychiatry and mental health [Child Adolesc Psychiatry Ment Health] 2024 Oct 17; Vol. 18 (1), pp. 131. Date of Electronic Publication: 2024 Oct 17.
DOI:	10.1186/s13034-024-00819-8
Abstrakt:	Background: Despite widespread use of higher levels of care in treating eating disorders in adolescents, research supporting the use of these treatments remains limited by small sample sizes and a predominant focus on anorexia nervosa. Further, existing data regarding predictors of outcome have yielded mixed findings. In the current study, we evaluated treatment outcomes and predictors of outcome among a large sample of adolescents with eating disorders presenting to inpatient, residential, partial hospitalization programs, and intensive outpatient programs across the United States. Methods: Adolescents (N = 1,971) completed self-report measures of eating disorder symptoms, depression, and anxiety at treatment admission, stepdown, and discharge. Using linear mixed effect models, we evaluated changes in symptoms over treatment separately among youth admitted to inpatient/residential treatment and those admitted to partial hospitalization/intensive outpatient programs, and used established metrics to gauge frequency of reliable (i.e., statistically reliable) and clinically significant change. Results: Results suggested decreases in eating disorder symptoms, depression, and anxiety from intake to discharge. Around 50% of the sample reported reliable decreases in eating disorder symptoms at stepdown and discharge, with 30% of the sample reporting reliable reductions in depression and anxiety. Psychiatric comorbidity, primary diagnosis, age, and eating disorder symptoms at admission consistently predicted treatment-related change, although patterns in findings varied across symptoms. Conclusions: Data from our sample are consistent with past work suggesting that adolescents enrolled in higher levels of care report clinical benefit; however, these effects are heterogenous, and a significant portion of individuals may not report reliable change in symptoms. Ultimately, ongoing work is required to better understand how and for whom higher levels of care may achieve their benefit and to identify the optimal approach for improving outcomes for adolescents with eating disorders. (© 2024. The Author(s).)
Databáze:	MEDLINE
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