Predictors of dropout from inpatient treatment for anorexia nervosa: data from a large French sample.
Dropout from anorexia nervosa inpatient treatment programs is frequent and is linked to a poorer outcome. This study aimed to identify predictive factors for dropout among anorexia nervosa inpatients. Between 1988 and 2004, 601 consecutive female inpatients with anorexia, restrictive (AN-R) or binge/purging (AN-B/P) subtype (Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV)), were assessed at admission (clinical, socio-demographic, and psychological data). A stepwise logistic model was developed. Dropout rates were respectively 50.0% and 56.2% for AN-R and AN-B/P. Seven predictive factors were identified in multivariate analysis: having one or more children, low desired body mass index (BMI), a low minimum BMI, high scores on the SCL-90 paranoid ideation and the Morgan and Russell eating behavior subscales, and low educational status. Early dropouts had a particular profile: lower desired BMI, higher score on SCL90 paranoid subscale, and more impulsive behaviors (alcohol use, suicide attempts). Dropout appeared as a multifactorial event. In clinical practice, certain factors could serve as warning messages reflecting the severity of the illness (high EDI score and low minimum BMI); while others could be targeted before hospitalization (having at least one child and low desired BMI).
Huas
Caroline
C
Inserm, U669, Paris, France. carohuas@gmail.com
Godart
Nathalie
N
Foulon
Christine
C
Pham-Scottez
Alexandra
A
Divac
Snezana
S
Fedorowicz
Valérie
V
Peyracque
Emilie
E
Dardennes
Roland
R
Falissard
Bruno
B
Rouillon
Frédéric
F
D000856:Anorexia Nervosa / Q000453:epidemiology / Q000523:psychology* / Q000628:therapy*; D015992:Body Mass Index; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D007297:Inpatients; D016015:Logistic Models; D010352:Patient Dropouts / Q000523:psychology* / Q000706:statistics & numerical data; D010555:Personality Inventory; D011237:Predictive Value of Tests; D011594:Psychometrics; D012189:Retrospective Studies; D057566:Self Report; D011795:Surveys and Questionnaires