Reprinted from Eating Disorders Review
May/June 2003 Volume 13, Number 3
©2002 Gürze Books
A treatment program based on establishing relationships and understanding has a positive and lasting effect on the severity of symptoms in female patients, according to two clinicians at Rogers Memorial Hospital, Ocononowic, WI (Eating Weight Disord 2001; 6:197). Pamela Bean, PhD, and Theodore Weltzin, MD, recently described their study of symptom changes among 99 consecutive bulimic and anorexic patients between admission and 6 months after discharge. A group of non-patient female college students acted as controls.
The Residential Eating Disorder Treatment Center at Rogers Memorial Hospital provides long-term treatment in a home-like setting. Patients participate in a program of daily living activities, psychotherapy, nutritional counseling, and health maintenance. Each has an individualized treatment plan, and may take part in a variety of programs, including family therapy, experiential and movement therapies, education-school collaboration, and a weekend family program. According to the authors, residential treatment is less expensive than inpatient therapy, yet is more intense than outpatient or partial treatment programs.
Symptom severity was measured with the Eating Disorders Inventory
The severity of symptoms was gauged with the eight subscales of the Eating Disorders Inventory (EDI). These subscales measure drive for thinness, bulimia, body dissatisfaction, ineffectiveness, perfectionism, interpersonal distrust, interoceptive awareness, and maturity fears. Anorexic and bulimic patients were analyzed separately.
Improvement in all sectors
The 47 bulimic patients had statistically significant improvements in all eight subscales of the EDI. The greatest reduction in symptom severity occurred in drive for thinness, bulimia, ineffectiveness, interoceptive awareness, and interpersonal distrust. The mean scores for body dissatisfaction on admission also improved after treatment.
The 52 anorexic patients showed similar statistically significant improvements in all 8 subscales of the EDI. The greatest reductions in symptom severity occurred in the same 4 subscales that showed the greatest improvement among the bulimic group: drive for thinness, interoceptive awareness, ineffectiveness, and feeling of interpersonal distrust. Significant changes also occurred in perfectionism and maturity fears.
Six months later
To date, 25 patients have completed and returned the EDI form. The authors are following up with these patients. Mean scores thus far are similar to those recorded at discharge, indicating that some improvements in symptom severity were maintained for at least 6 months in both groups of patients. Longer-term studies are needed to see the degree to which these improvements are sustained over time. Other studies are needed to compare the relatively effectiveness of residential treatment to traditional inpatient and intensive outpatient interventions.