title: Long-term outcome of residential treatment for anorexia nervosa and bulimia nervosa.
abstract: We analyzed results from surveys of respondents who had completed ≥ 30 days of treatment at Monte Nido Residential Treatment Program over a 10 year period. Participants with anorexia nervosa (AN; n = 66) and bulimia nervosa (BN; n = 52) completed the Eating Disorders Inventory-2 (EDI-2), the Beck Depression Inventory (BDI), and a structured eating disorder assessment at admission and follow-up. Mean duration between discharge and last follow-up was 4.6 years and 3.8 years for AN and BN respectively. For AN there were significant improvements in BMI, BDI, 10 of 11 EDI-2 subscales, and frequencies of bingeing and purging. For BN there were significant improvements in BDI, all EDI subscales, and frequencies of bingeing and purging. Eighty-nine percent of AN graduates and 75% of BN graduates had good or intermediate outcomes. Using linear regression, the best model contained the single variable, discharge BMI, which predicted 23% of the variance explaining full recovery from AN (p ≤ .02). For BN, the best model contained vomiting frequency and the bulimia subscale score of the EDI-2 at discharge, which accounted for 37% of the variance explaining full recovery from BN (p ≤ .02). The great majority of patients showed significant improvement at long-term follow-up after this program of residential treatment. In addition, these results underscore the importance of weight gain for AN patients and cessation of bulimic symptoms for BN patients when predicting long-term recovery.
authors.affiliation: Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA. tbrewerton1@comcast.net
authors.forename: Timothy D
authors.initials: TD
authors.lastname: Brewerton
authors.forename: Carolyn
authors.initials: C
authors.lastname: Costin
mesh_terms: D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D000856:Anorexia Nervosa / Q000628:therapy*; D001828:Body Image; D015992:Body Mass Index; D052018:Bulimia Nervosa / Q000628:therapy*; D005500:Follow-Up Studies; D006801:Humans; D016014:Linear Models; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D011613:Psychotherapy / Q000379:methods*; D012114:Residential Treatment; D013995:Time; D016896:Treatment Outcome