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Treatment adherence and the care programme approach in individuals with eating disorders

  • Martin Schmidt (a1), John F. Morgan (a2) and Farida Yousaf (a3)
Abstract
Aims and Method

To examine service-level variables predicting treatment adherence in a specialist eating disorder unit. We analysed a sample of 157 individuals consecutively referred to the unit over an 18-month period. Associations were determined using odds ratios.

Results

Individuals with a formal care programme at the point of referral were more likely to stay in treatment. Treatment adherence was not predicted by illness severity or waiting time. Follow-up by a dietician and acceptance of referral to a support group predicted better treatment outcomes.

Clinical Implications

Although the standard care programme approach may be relinquished in the UK, we recommend that this approach or its equivalent be used in specialist eating disorder services to improve treatment adherence.

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Copyright
This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
References
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American Psychiatric Association (1994) Diagnostic and Statistical Manual of Mental Disorders (4th edn) (DSM–IV). APA.
Arcelus, J., Bouman, W. P. & Morgan, J. F. (2007) Treating young people with eating disorders: transition from child mental health to specialist adult eating disorder services. European Eating Disorders Review, 16, 3036.
Clinton, D. N. (1996) Why do eating disorder patients drop out? Psychotherapy and Psychosomatics, 65, 2935.
Department of Health (1999a) Effective Care Coordination in Mental Health Services: Modernising the Care Programme Approach. Department of Health.
Department of Health (1999b) National Service Framework for Mental Health: Modern Standards and Service Models. Department of Health.
Department of Health (2006) Reviewing the Care Programme Approach. Department of Health.
Feld, R., Woodside, D. B., Kaplan, A. S., et al (2001) Pre-treatment motivational enhancement therapy for eating disorders: a pilot study. International Journal of Eating Disorders, 29, 393400.
Morgan, J. F. (2007) Giving Up the Culture of Blame: Risk Assessment and Risk Management in Psychiatric Practice. Royal College of Psychiatrists.
National Institute for Health and Clinical Excellence (2004) Eating Disorders: Core Interventions in the Treatment and Management of Anorexia Nervosa, Bulimia Nervosa and Related Eating Disorders. National Collaborating Centre for Mental Health.
Treasure, J., Schmidt, U. & Hugo, P. (2005) Mind the gap: service transition and interface problems for patients with eating disorders. British Journal of Psychiatry, 187, 398400.
Williams, G. J., Power, K.G., Miller, H. R., et al (1994) Development and validation of the Stirling Eating Disorder Scales. International Journal of Eating Disorders, 16, 3543.
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BJPsych Bulletin
  • ISSN: 0955-6036
  • EISSN: 1472-1473
  • URL: /core/journals/bjpsych-bulletin
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Treatment adherence and the care programme approach in individuals with eating disorders

  • Martin Schmidt (a1), John F. Morgan (a2) and Farida Yousaf (a3)
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