Intensive Treatments in Adolescent Anorexia Nervosa.

Publisher: MDPI Publishing Country of Publication: Switzerland NLM ID: 101521595 Publication Model: Electronic Cited Medium: Internet ISSN: 2072-6643 (Electronic) Linking ISSN: 20726643 NLM ISO Abbreviation: Nutrients Subsets: MEDLINE

Original Publication: Basel, Switzerland : MDPI Publishing

Adolescent Health Services/*organization & administration ; Anorexia Nervosa/*therapy ; Critical Care/*methods ; Nutritional Support/*methods ; Psychotherapy/*methods; Adolescent ; Ambulatory Care/methods ; Ambulatory Care/organization & administration ; Anorexia Nervosa/mortality ; Anorexia Nervosa/psychology ; Body Mass Index ; Caregivers ; Critical Care/organization & administration ; Health Policy ; Home Care Services, Hospital-Based/organization & administration ; Hospitalization ; Humans ; Parents ; Quality of Health Care ; Stakeholder Participation ; Treatment Outcome

Approximately one-fifth to one-third of patients with adolescent anorexia nervosa (AN) need intensive care in the course of their illness. This article provides an update and discussion on different levels of intensive care (inpatient treatment (IP), day patient treatment (DP) and home treatment (HoT)) in different health care systems based on recently published literature. Important issues discussed in this article are new recommendations for the refeeding process and the definition of target weight as well as principles of medical stabilization and psychotherapeutic approaches. The pros and cons of longer or shorter hospitalization times are discussed, and the advantages of stepped care and day patient treatment are described. A new promising intensive treatment method involving the patient, their caregivers and the direct home environment is introduced. Parents and caregivers should be included in treatment research to foster collaborative work with the attending clinicians. There is an urgent need to evaluate the mid- to long-term outcomes of various intensive treatment programs to compare their effectiveness and costs across different health care systems. This could help policy makers and other stakeholders, such as public and private insurances, to enhance the quality of eating disorder care.

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01EW1906A European Commission; 01VSF20006 Federal Joint Committee Germany

Keywords: adolescence; anorexia nervosa; day patient treatment; home treatment; hospitalization; inpatient treatment; intensive care; refeeding; target weight

Date Created: 20210430 Date Completed: 20210607 Latest Revision: 20240401

20240401

PMC8068891

10.3390/nu13041265

33924294