Sarah Vibert

Dropout from Inpatient Treatment for Anorexia Nervosa: Critical Review of the Literature

OBJECTIVE High dropout rates from inpatient treatment for Anorexia Nervosa (AN) pose a serious obstacle to successful treatment. Because dropping out of inpatient treatment may have a negative impact on outcome, it is important to understand why dropout occurs so that treatment can be targeted toward keeping patients in care. We therefore conducted a critical literature review of studies on dropout from inpatient treatment for AN. METHOD Searches of Medline and PsycINFO revealed nine articles on this subject. Two were excluded because they did not differentiate AN from other eating disorders in analyses. RESULTS Results were scarce and conflicting, with methodological issues complicating comparisons. Weight on admission, AN subtype, eating disorder symptoms, greater psychiatric difficulty in general, and the absence of depression were related to dropout in multivariate analyses. DISCUSSION Authors should use a common definition of dropout and continue research on the identified predictors as well as potential predictors such as impulsivity and family factors.

Expressed Emotion in Families of Patients with Eating Disorders: A Review of the Literature

Objective: To review studies assessing Expressed Emotion among parents/relatives of patients with Anorexia Nervosa and Bulimia Nervosa. Method: A systematic computerized search was performed in Medline complemented by a manual search of the literature for all studies published between 1981 and 2011. A total of 27 papers in English were reviewed for their methods, instruments used and results. Results: Comparisons were not easy due to methodological disparities in assessments. Levels of Expressed Emotion depend concurrently on parental characteristics (parent assessed, social status and psychological distress), patient characteristics (age, social adjustment) and Eating Disorders characteristics (type of Eating Disorders, duration and severity of illness and previous treatment). Expressed Emotion has a predictive value for patient outcome and for compliance with/ and implication in treatment. Levels of Expressed Emotions vary with the parent assessed. The crosscultural aspects of Expressed Emotion in Eating Disorders are not widely documented. Discussion: Both positive and negative aspects of Expressed Emotion are important therapeutic targets and further research on this topic is needed.

Family history of anxiety and mood disorders in anorexia nervosa: Review of the literature

OBJECTIVE: To provide a critical review of the research on mood and anxiety disorders in relatives of individuals with anorexia nervosa (AN). In the first section, we explore methodological issues with these studies. In the second section, we present results. METHOD: A Medline search identified studies published on family history of mood and anxiety disorders in AN, and was complemented by a manual search. Only studies from 1980 to 2006 using strict diagnostic criteria for the disorders were included [Feighner and Halmi criteria for AN, Reasearch Diagnostic Criteria (RDC), Diagnostic and Statistical Manual of Mental Disorders — Third Edition — Revised (DSM-III-R) or DSM — Fourth Edition (DSM-IV) for anorexia and other disorders]. RESULTS: A review of the research methods used in the studies revealed a number of methodological problems. Therefore, we provide only a description of the prevalence of mood and anxiety disorders in relatives of individuals with AN. CONCLUSIONS: In the light of the methodological issues uncovered, the value of the results of these studies and their implications for further study are considered.

Contents Vol. 46, 2013

Founded 1897 as ‘Monatsschrift für Psychiatrie und Neurologie’, continued 1957–1967 as ‘Psychiatria et Neurologia’, continued 1968–1983 as ‘Psychiatria Clinica’ Founders: C. Wernicke and Th . Ziehen Successors: K. Bonhoeff er (1912–1938), J. Klaesi (1939–1967), E. Grünthal (1953–1973), N. Petrilowitsch (1968–1970), Th . Spoerri (1971–1973), P. Berner (1974–1999), E. Gabriel (1974–2004), Ch. Mundt (2000–2011)