title: Drop-out from adolescent and young adult inpatient treatment for anorexia nervosa.
abstract: We examined factors predictive of dropout from inpatient treatment for anorexia nervosa (AN) among adolescents in a prospective study of 359 consecutive hospitalizations for AN (DSM-IV). Patients were assessed at admission (clinical, socio-demographic, and psychological data). Multivariate analyses were performed. Drop-out (i.e. leaving hospital before the target weight is achieved) occurred in 24% (n=86) of hospitalizations; in 42.3% (n=30) of the cases, dropout was initiated by the treatment team and in 58.6% (n=41) by the patients and/or their parents. 18.6% (16/86) occurred during the first half of the inpatient program. Frequency of drop-out was significantly higher when the patient was living with only one parent, had been hospitalized previously, had a lower BMI at admission and was over 18 at admission. These elements should draw the attention of the clinician, so that he/she can prepare hospitalization with patients presenting lower admission BMI, particularly by motivational interventions for a better therapeutic alliance, and by the deployment of intensive accompaniment of single parents. Further studies aiming to replicate these results, and including the evaluation of other clinical dimensions such as impulsivity and other personality traits, are needed to elucidate this important topic.
authors: Department of Psychiatry, Institut Mutualiste Montsouris (IMM), Paris, France; Department of General Practice, Univ Paris 7 Denis Diderot., Paris, France; Ecole des Hautes Etudes en Santé Publique (EHESP), Rennes, France; Univ. Paris Ouest Nanterre La Defense, Nanterre, France.
authors: Tamara
authors: T
authors: Hubert
authors: Philippe
authors: P
authors: Pioggiosi
authors: Caroline
authors: C
authors: Huas
authors: Jenny
authors: J
authors: Wallier
authors: Anne-Solène
authors: AS
authors: Maria
authors: Alexandre
authors: A
authors: Apfel
authors: Florence
authors: F
authors: Curt
authors: Bruno
authors: B
authors: Falissard
authors: Nathalie
authors: N
authors: Godart
mesh_terms: D000293:Adolescent; D000704:Analysis of Variance; D000856:Anorexia Nervosa / Q000523:psychology* / Q000628:therapy; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D016015:Logistic Models; D008297:Male; D010352:Patient Dropouts / Q000523:psychology* / Q000706:statistics & numerical data; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Adolescent; Anorexia nervosa; Dropout; Inpatient