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Mod5 Art2 - Module 5 Article 2 TREATMENT HIGHLIGHTS RELAPSE...

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Unformatted text preview: Module 5 --- Article 2 TREATMENT HIGHLIGHTS RELAPSE IN ANOREXIA NERVOSA Several cognitive and behavioral variables are found to be associated with relapse in anorexia nervosa. This study sought to determine which factors contributed to relapse in anorexia nervosa among women participating in an intensive group therapy program. 51 female patients who had achieved weight restoration during inpatient treatment were assessed at admission and discharge from the hospital, and at a followup interview 6 to 27 months after discharge. The average followup period was 15.6 months. Weight was considered restored if body mass index (BMI)1 reached at least 20. Relapse was considered to have occurred if body mass index dropped to below 17.5. During the followup period, 35% of the patients relapsed, with the greatest risk of relapse occurring between 6 and 17 months after discharge from the hospital. The risk of relapse increased if any of the following factors were present: history of suicide attempt(s), prior treatment for an eating disorder, relatively severe washing compulsions and rumination at discharge, excessive exercise to control weight or shape shortly after discharge (ie, intensive exercise averaging 6 hours or more per week for at least 3 months). The risk of relapse decreased if, during the hospital treatment, there was a reduction in problem avoidance and/or a reduction in concerns about shape, weight, and eating. The authors also note that even among the patients who did not relapse, a majority did not maintain an optimal weight (a BMI of at least 20), and it is unknown how many relapsed subsequent to the followup interview. The authors conclude that “long-term followup care aimed at preventing relapse in AN [anorexia nervosa] is needed following weight-restoration treatment.” They suggest that it is important that treatment address excessive physical activity and also address cognitive distortions about shape and weight. In addition, it is suggested that treatment focus on developing the patient’s coping strategies. 1 BMI = [weight in kilograms] divided by [height in meters, squared]. Carter JC, Blackmore E, Sutandar-Pinnock K, & Woodside DB. Relapse in anorexia nervosa: A survival analysis. Psychological Medicine, 34:671-679, 2004. Support: Canadian Institutes of Health Research. © Copyright 2011 MWK Publishing LLC; from The Complete Practitioner: Mental Health Applications (Vol. 7, No. 12 -- December 2004) For next article, go to next page. ...
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