Original presentation and abstract by professor Beate Herpertz-Dahlmann (University of Aachen, Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Aachen, Germany) on her randomized controlled non-inferiority trial of day patient treatment in comparison to inpatient treatment among adolescent patients with anorexia nervosa, held at the ESCAP 2013 Congress in Dublin, Sunday 7th July 2013.
Introduction: There are very few randomized, controlled studies exploring the effectiveness of treatment setting in adolescent Anorexia nervosa (AN).
Method: In this multicenter trial, 176 female adolescents with a first admission for AN were randomized to either continued IP or DP treatment after a three-week inpatient stabilization period. The treatment program did not differ between the study arms.
Results: DP was not inferior to IP with respect to weight gain at the 1-year follow-up (p\0.0001). Patients in the DP arm tended to have better psychosocial outcomes. The number of treatment-related serious adverse events did not differ between the study arms.
Conclusions: DP treatment after short inpatient medical stabilization in adolescent patients with non-chronic AN was as effective as IP for weight restoration and thus may be a safe and less costly alternative to IP. Various prognostic factors as well as treatment acceptance will be analyzed and presented.
Keywords: Anorexia Nervosa; inpatient treatment; adolescent patients.
Following from her presentation in Dublin, the data was published in the Lancet
Day patients arrive at 8.00 in the morning and leave at 4.30 p.m. Day patient treatment is more costly than outpatient treatment, but not as high as in inpatient treatment (hospitalization).
A research team at RWTH Aachen University (Germany), led by professor Beate Herpertz-Dahlmann, had the study published in The Lancet on 17 January 2014. Professor Dr Herpertz-Dahlmann is director of the department of child and adolescent psychiatry and is a member of the ESCAP Board. This multicenter, randomized, open-label, non-inferiority trial involved 172 girls, aged 11-18 years, who were randomly allocated to hospital treatment (85) and day patient treatment (87).
The Aachen researchers found that girls who were in day treatment did as well as others who had to stay in hospital for months to receive their therapy. The study concludes that day patient treatment (DP) after a short inpatient care (IP) in adolescent patients with non-chronic anorexia nervosa seems no less effective than IP for weight restoration and maintenance during the first year after admission. “Thus, DP might be a safe and less costly alternative to IP. Our results justify the broad implementation of this approach”, the researchers say.
Less burdensome, less expensive
Dr Beate Herpertz-Dahlmann who treated many anorexic patients during here career, said to a Reuters reporter: "When I saw them when they were a little bit older, they would tell me they lost their youth by being in the hospital so long." The study indicates that the day patients performed better than hospitalized patients on measures of mental health, which Herpertz-Dahlmann said is probably a result of the girls being allowed to live in their homes with their families. By justifying day patient care for these patients, this study opens doors to anorexia nervosa treatments that are less burdensome and less expensive.