King's College London

Research portal

The impact of duration of illness on treatment nonresponse and drop-out: Exploring the relevance of enduring eating disorder concept

Research output: Contribution to journalArticlepeer-review

Fernando Fernández-Aranda, Janet Treasure, Georgios Paslakis, Zaida Agüera, Mónica Giménez, Roser Granero, Isabel Sánchez, Eduardo Serrano-Troncoso, Philip Gorwood, Beate Herpertz-Dahlmann, Eva Maria Bonin, Palmiero Monteleone, Susana Jiménez-Murcia

Original languageEnglish
Pages (from-to)499-513
Number of pages15
JournalEuropean Eating Disorders Review
Volume29
Issue number3
DOIs
Accepted/In press2021
PublishedMay 2021

Bibliographical note

Funding Information: The authors would like to thank CERCA Programme/Generalitat de?Catalunya for institutional support. This manuscript and research was supported by grants from the Ministerio de Econom?a y Competitividad (PSI2015-68701-R), by the Delegaci?n del Gobierno para el plan Nacional sobre Drogas (2017I067), by the Instituto de Salud Carlos III (ISCIII) (FIS PI14/00290 and PI17/01167), by the SLT006/17/00246 grant, funded by the Department of Health of the Generalitat de Catalunya by the call ?Acci? instrumental de programes de recerca orientats en l'?mbit de la recerca i la innovaci? en salut? and co-funded by FEDER funds/European Regional Development Fund (ERDF), a way to build Europe. CIBERObn and CIBERSAM are both initiatives of ISCIII. The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. Janet Treasure acknowledges financial support from the National Institute for Health Research (NIHR) Specialist Biomedical Research Centre for Mental Health award to the South London and Maudsley NHS Foundation Trust and the Institute of Psychiatry, King's College London. This article has been produced in the frame of the research conducted by the Working group on Anorexia Nervosa of the ?Value of Treatment? project, led by the European Brain Council (EBC) and supported by the European Psychiatric Association (EPA). Experts of the Anorexia Nervosa working group: Janet Treasure (Chair), Eva Bonin, Philip Gorwood, Palmiero Monteleone, Beate Herpertz-Dahlmann, Fernando Fernandez-Aranda, Miia M?nnikk? and Jacinta Hastings. Funding Information: The authors would like to thank CERCA Programme/Generalitat de Catalunya for institutional support. This manuscript and research was supported by grants from the Ministerio de Economía y Competitividad (PSI2015‐68701‐R), by the Delegación del Gobierno para el plan Nacional sobre Drogas (2017I067), by the Instituto de Salud Carlos III (ISCIII) (FIS PI14/00290 and PI17/01167), by the SLT006/17/00246 grant, funded by the Department of Health of the Generalitat de Catalunya by the call “Acció instrumental de programes de recerca orientats en l'àmbit de la recerca i la innovació en salut” and co‐funded by FEDER funds/European Regional Development Fund (ERDF), a way to build Europe. CIBERObn and CIBERSAM are both initiatives of ISCIII. The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. Janet Treasure acknowledges financial support from the National Institute for Health Research (NIHR) Specialist Biomedical Research Centre for Mental Health award to the South London and Maudsley NHS Foundation Trust and the Institute of Psychiatry, King's College London. This article has been produced in the frame of the research conducted by the Working group on Anorexia Nervosa of the “Value of Treatment” project, led by the European Brain Council (EBC) and supported by the European Psychiatric Association (EPA). Experts of the Anorexia Nervosa working group: Janet Treasure (Chair), Eva Bonin, Philip Gorwood, Palmiero Monteleone, Beate Herpertz‐Dahlmann, Fernando Fernandez‐Aranda, Miia Männikkö and Jacinta Hastings. Publisher Copyright: © 2020 Eating Disorders Association and John Wiley & Sons Ltd. Copyright: Copyright 2021 Elsevier B.V., All rights reserved.

King's Authors

Abstract

Objective: There are no generally accepted definitions or markers of treatment nonresponse in eating disorders (EDs). The aim of this paper was to examine how the duration of illness and other potential prognostic markers impacted on nonresponse and drop-out from treatment across different EDs subtypes. Methods: A total sample of 1199 consecutively treated patients with EDs, according to Diagnostic and Statistical Manual of Mental Disorders, fifth edition criteria, participated in this study. Kaplan–Meier curves were calculated for each ED diagnosis in which the probability of recovery was plotted against the duration of illness. Results: Full remission was more likely for people with binge eating disorder (BED; 47.4%) and anorexia nervosa (AN; 43.9%) compared to bulimia nervosa (BN; 25.2%) and other specified feeding and EDs (OSFED; 23.2%). The cut-off points for the duration of the illness related with high likelihoods of poor response was 6–8 years among OSFED, 12–14 years among AN and BN and 20–21 years among BED. Other variables predicting nonresponse included dysfunctional personality traits. Conclusions: Nonresponse to treatment is associated with duration of illness which is in turn associated with poor response to previous treatment. However, there was no evidence for staging the illness using specific duration of illness criteria. Nevertheless, the shorter temporal trajectory for OSFED suggests that early interventions may be of importance for this group.

View graph of relations

© 2020 King's College London | Strand | London WC2R 2LS | England | United Kingdom | Tel +44 (0)20 7836 5454