Inpatient versus day clinic treatment for bulimia nervosa: a randomized trial.
BACKGROUND
In bulimia nervosa, more intense treatments are recommended if outpatient treatment fails. This is the first randomized controlled trial comparing the options of inpatient versus day clinic treatment.


METHODS
Patients with severe bulimia nervosa were randomly assigned to inpatient or day clinic treatment of similar length and intensity. Specific and general psychopathology was assessed at the end of treatment and a 3-month follow-up.


RESULTS
Fifty-five patients were randomized; 22 day clinic patients and 21 inpatients started the program. At the end of treatment, a significant reduction of general and specific pathology was found in both settings. Following discharge, there was more deterioration in bulimic symptoms after inpatient treatment, but overall, results were comparable.


CONCLUSIONS
Inpatient and day clinic programs are effective treatments for severely disturbed bulimic patients with similar results at the 3-month follow-up. Further follow-up will show if a higher instability of results after inpatient treatment is of importance in the long term.
Zeeck
Almut
A
Department of Psychosomatic Medicine and Psychotherapy, University of Freiburg, Hauptstrasse 8, Freiburg, Germany. almut.zeeck@uniklinik-freiburg.de
Weber
Stefanie
S
Sandholz
Angelika
A
Wetzler-Burmeister
Edda
E
Wirsching
Michael
M
Hartmann
Armin
A
D000328:Adult; D000553:Ambulatory Care; D052018:Bulimia Nervosa / Q000175:diagnosis / Q000534:rehabilitation / Q000628:therapy*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D038801:International Classification of Diseases; D008297:Male; D010352:Patient Dropouts / Q000706:statistics & numerical data; D012074:Remission Induction; D012720:Severity of Illness Index; D016896:Treatment Outcome