Hostname: page-component-76fb5796d-x4r87 Total loading time: 0 Render date: 2024-04-25T15:11:07.041Z Has data issue: false hasContentIssue false
  • English
  • Français

Involuntary treatment in patients with anorexia nervosa: utilization patterns and associated factors

Published online by Cambridge University Press:  28 September 2021

Benjamin Mac Donald Open the ORCID record for Benjamin Mac Donald [Opens in a new window] ,
Cynthia M. Bulik Open the ORCID record for Cynthia M. Bulik [Opens in a new window] ,
Janne T. Larsen Open the ORCID record for Janne T. Larsen [Opens in a new window] ,
Anders H. Carlsen ,
Loa Clausen Open the ORCID record for Loa Clausen [Opens in a new window]  and
Liselotte V. Petersen Open the ORCID record for Liselotte V. Petersen [Opens in a new window]
Benjamin Mac Donald*
Affiliation:
Department of Clinical Medicine, Aarhus University, Aarhus, Denmark Department of Child and Adolescent Psychiatry, Aarhus University Hospital, Aarhus, Denmark
Cynthia M. Bulik
Affiliation:
Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
Janne T. Larsen
Affiliation:
The National Centre for Register-based Research, Aarhus University, Aarhus, Denmark Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus University, Aarhus, Denmark Centre for Integrated Register-based Research (CIRRAU), Aarhus University, Aarhus, Denmark
Anders H. Carlsen
Affiliation:
Department of Clinical Medicine, Aarhus University, Aarhus, Denmark Department of Child and Adolescent Psychiatry, Aarhus University Hospital, Aarhus, Denmark
Loa Clausen
Affiliation:
Department of Clinical Medicine, Aarhus University, Aarhus, Denmark Department of Child and Adolescent Psychiatry, Aarhus University Hospital, Aarhus, Denmark
Liselotte V. Petersen
Affiliation:
The National Centre for Register-based Research, Aarhus University, Aarhus, Denmark Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus University, Aarhus, Denmark Centre for Integrated Register-based Research (CIRRAU), Aarhus University, Aarhus, Denmark
*
Author for correspondence: Benjamin Mac Donald, E-mail: zychologist@hotmail.com
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

A subgroup of patients with anorexia nervosa (AN) undergoing involuntary treatment (IT) seems to account for most of the IT events. Little is known about these patients and their treatment including the temporal distribution of IT events and factors associated with subsequent utilization of IT. Hence, this study explores (1) utilization patterns of IT events, and (2) factors associated with subsequent utilization of IT in patients with AN.

Methods

In this nationwide Danish register-based retrospective exploratory cohort study patients were identified from their first (index) hospital admission with an AN diagnosis and followed up for 5 years. We explored data on IT events including estimated yearly and total 5-year rates, and factors associated with subsequent increased IT rates and restraint, using regression analyses and descriptive statistics.

Results

IT utilization peaked in the initial few years starting at or following the index admission. A small percentage (1.0%) of patients accounted for 67% of all IT events. The most frequent measures reported were mechanical and physical restraint. Factors associated with subsequent increased IT utilization were female sex, lower age, previous admissions with psychiatric disorders before index admission, and IT related to those admissions. Factors associated with subsequent restraint were lower age, previous admissions with psychiatric disorders, and IT related to these.

Conclusions

High IT utilization in a small percentage of individuals with AN is concerning and can lead to adverse treatment experiences. Exploring alternative approaches to treatment that reduce the need for IT is an important focus for future research.

Keywords

Anorexia nervosacoercioncompulsory treatmenteating disordersepidemiological factorsinvoluntary treatmentsevere and enduring anorexia nervosa
Type
Original Article
Information
Psychological Medicine , Volume 53 , Issue 5 , April 2023 , pp. 1999 - 2007
Check for updates
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

*

Drs. Clausen and Petersen contributed equally to the study and share senior authorship.

References

Akther, S. F., Molyneaux, E., Stuart, R., Johnson, S., Simpson, A., & Oram, S. (2019). Patients' experiences of assessment and detention under mental health legislation: Systematic review and qualitative meta-synthesis. The British Journal of Psychiatry Open, 5, e37. doi:10.1192/bjo.2019.19CrossRefGoogle ScholarPubMed
Arcelus, J., Mitchell, A., Wales, J., & Nielsen, S. (2011). Mortality rates in patients with anorexia nervosa and other eating disorders: A meta-analysis of 36 studies. Archives of General Psychiatry, 68, 724–731. doi:10.1001/archgenpsychiatry.2011.74CrossRefGoogle ScholarPubMed
Atti, A. R., Mastellari, T., Valente, S., Speciani, M., Panariello, F., & De Ronchi, D. (2021). Compulsory treatments in eating disorders: A systematic review and meta-analysis. Eating and Weight Disorders – Studies on Anorexia, Bulimia and Obesity, 26(4), 1037–1048. doi:10.1007/s40519-020-01031-1CrossRefGoogle ScholarPubMed
Ayton, A., Keen, C., & Lask, B. (2009). Pros and cons of using the mental health act for severe eating disorders in adolescents. European Eating Disorders Review: The Journal of the Eating Disorders Association, 17, 14–23. doi:10.1002/erv.887CrossRefGoogle ScholarPubMed
Bak, J., & Aggernæs, H. (2012). Coercion within Danish psychiatry compared with 10 other European countries. Nordic Journal of Psychiatry, 66(5), 297–302. doi:10.3109/08039488.2011.632645CrossRefGoogle ScholarPubMed
Blikshavn, T., Halvorsen, I., & Rø, Ø. (2020). Physical restraint during inpatient treatment of adolescent anorexia nervosa: Frequency, clinical correlates, and associations with outcome at five-year follow-up. Journal of Eating Disorders, 8, 20. doi:10.1186/s40337-020-00297-1CrossRefGoogle ScholarPubMed
Carney, T., Crim, D., Wakefield, A., Tait, D., & Touyz, S. (2006). Reflections on coercion in the treatment of severe anorexia nervosa. Israel Journal of Psychiatry and Related Sciences, 43(3), 159–165. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/17294981.Google ScholarPubMed
Chesney, E., Goodwin, G. M., & Fazel, S. (2014). Risks of all-cause and suicide mortality in mental disorders: A meta-review. World Psychiatry, 13, 153–160. doi:10.1002/wps.20128CrossRefGoogle ScholarPubMed
Clausen, L., & Jones, A. (2014). A systematic review of the frequency, duration, type and effect of involuntary treatment for people with anorexia nervosa, and an analysis of patient characteristics. Journal of Eating Disorders, 2, 29. doi:10.1186/s40337-014-0029-8CrossRefGoogle Scholar
Clausen, L., Larsen, J. T., Bulik, C. M., & Petersen, L. (2018). A Danish register-based study on involuntary treatment in anorexia nervosa. International Journal of Eating Disorders, 51, 1213–1222. doi:10.1002/eat.22968CrossRefGoogle Scholar
DeLacy, L., Edner, B., Hart, C., McCann, K., Szpak, C., & Johnson, B. (2003). Learning from each other: Success stories and ideas for reducing restraint/seclusion in behavioural health. Retrieved from https://www.nabh.org/wp-content/uploads/2018/06/LearningfromEachOtherFINAL.pdf.Google Scholar
Di Lodovico, L., Duquesnoy, M., Dicembre, M., Ringuenet, D., Godart, N., Gorwood, P., … Hanachi, M. (2021). What distinguish patients with compulsory treatment for severely undernourished anorexia nervosa. European Eating Disorders Review: The Journal of the Eating Disorders Association, 29(1), 144–151. doi:10.1002/erv.2790CrossRefGoogle ScholarPubMed
Elzakkers, I. F. F. M., Danner, U. N., Hoek, H. W., Schmidt, U., & van Elburg, A. A. (2014). Compulsory treatment in anorexia nervosa: A review. International Journal of Eating Disorders, 47, 845–852. doi:10.1002/eat.22330CrossRefGoogle ScholarPubMed
Fassino, S., Pierò, A., Tomba, E., & Abbate-Daga, G. (2009). Factors associated with dropout from treatment for eating disorders: A comprehensive literature review. BioMed Central Psychiatry, 9(1), 67. doi:10.1186/1471-244X-9-67CrossRefGoogle ScholarPubMed
Finansministeriet. (2013). Aftaler om finansloven for 2014 [Agreements on the Finance Act for 2014]. Albertslund: Rosendahls-Schultz Grafisk. Retrieved from https://fm.dk/media/15111/Aftaleromfinanslovenfor2014_web.pdf.Google Scholar
Furre, A., Sandvik, L., Friis, S., Knutzen, M., & Hanssen-Bauer, K. (2016). A nationwide study of why and how acute adolescent psychiatric units use restraint. Psychiatry Research, 237, 60–66. doi:10.1016/j.psychres.2016.01.067CrossRefGoogle ScholarPubMed
Gooding, P., McSherry, B., & Roper, C. (2020). Preventing and reducing ‘coercion’ in mental health services: An international scoping review of English-language studies. Acta Psychiatrica Scandinavica, 142(1), 27–39. doi:10.1111/acps.13152CrossRefGoogle ScholarPubMed
Griffiths, R. A., Beumont, P. J., Russell, J., Touyz, S. W., & Moore, G. (1997). The use of guardianship legislation for anorexia nervosa: A report of 15 cases. Australian and New Zealand Journal of Psychiatry, 31, 525–531. doi:10.3109/00048679709065074CrossRefGoogle ScholarPubMed
Halmi, K. A. (2018). Psychological comorbidities of eating disorders. In Agras, S. W. & Robinson, A. (Eds.), The Oxford handbook of eating disorders (2nd ed., pp. 229–243). New York: Oxford University Press.Google Scholar
Hay, P., Chinn, D., Forbes, D., Madden, S., Newton, R., Sugenor, L., … Ward, W. (2014). Royal Australian and New Zealand college of psychiatrists clinical practice guidelines for the treatment of eating disorders. Australian and New Zealand Journal of Psychiatry, 48(11), 977–1008. doi:10.1177/0004867414555814CrossRefGoogle ScholarPubMed
Hudson, J. I., Hiripi, E., Pope, H. G., & Kessler, R. C. (2007). The prevalence and correlates of eating disorders in the national comorbidity survey replication. Biological Psychiatry, 61(3), 348–358. doi:10.1016/j.biopsych.2006.03.040CrossRefGoogle ScholarPubMed
Khalsa, S. S., Portnoff, L. C., McCurdy-McKinnon, D., & Feusner, J. D. (2017). What happens after treatment? A systematic review of relapse, remission, and recovery in anorexia nervosa. Journal of Eating Disorders, 5, 20. doi:10.1186/s40337-017-0145-3CrossRefGoogle ScholarPubMed
Kondo, T., Takaoka, K., Ikawa, N., & Niwa, N. (2004). Law relating to compulsory treatment of patients with anorexia nervosa. International Medical Journal, 11, 281–284.Google Scholar
Laakmann, G., Ortner, M., Kamleiter, M., Ufer, S., Frodl, T., Goldstein-Müller, B., … Stec, I. (2006). Behandlung vital gefährdeter Anorexia-nervosa-Patienten unter Berücksichtigung der Möglichkeiten des Betreuungsrechts [Treatment of vitally endangered anorexia nervosa patients based on guardianship laws]. Der Nervenarzt, 77, 35–49. doi:10.1007/s00115-004-1870-9CrossRefGoogle Scholar
Lynge, E., Sandegaard, J. L., & Rebolj, M. (2011). The Danish national patient register. Scandinavian Journal of Public Health, 39(7_suppl), 30–33. doi:10.1177/1403494811401482CrossRefGoogle ScholarPubMed
Mors, O., Perto, G. P., & Mortensen, P. B. (2011). The Danish psychiatric central research register. Scandinavian Journal of Public Health, 39, 54–57. doi:10.1177/1403494810395825CrossRefGoogle ScholarPubMed
National Mental Health Commission. (2012). A contributing life, the 2012 national report card on mental health and suicide prevention. Sydney: NMHC. Retrieved from https://www.mentalhealthcommission.gov.au/getmedia/9ab983bc-d825-41cf-ba04-a3d49e8d4257/Monitoring/2012-National-Report-Card-on-Mental-Health-and-Suicide-Prevention.pdf.Google Scholar
Pedersen, C. B. (2011). The Danish civil registration system. Scandinavian Journal of Public Health, 39(7 Suppl), 22–25. doi:10.1177/1403494810387965CrossRefGoogle ScholarPubMed
Puras, D. (2017). Report of the Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health. Retrieved from https://digitallibrary.un.org/record/1298436#record-files-collapse-header.Google Scholar
Ramsay, R., Ward, A., Treasure, J., & Russell, G. F. (1999). Compulsory treatment in anorexia nervosa. Short-term benefits and long-term mortality. British Journal of Psychiatry, 175, 147–153. doi:10.1192/bjp.175.2.147CrossRefGoogle ScholarPubMed
Sashidharan, S. P., Mezzina, R., & Puras, D. (2019). Reducing coercion in mental healthcare. Epidemiology and Psychiatric Sciences, 28(6), 605–612. doi:10.1017/S2045796019000350CrossRefGoogle ScholarPubMed
Seed, T., Fox, J., & Berry, K. (2016a). Experiences of detention under the mental health act for adults with anorexia nervosa. Clinical Psychology & Psychotherapy, 23(4), 352–362. doi:10.1002/cpp.1963CrossRefGoogle ScholarPubMed
Seed, T., Fox, J. R. E., & Berry, K. (2016b). The experience of involuntary detention in acute psychiatric care. A review and synthesis of qualitative studies. International Journal of Nursing Studies, 61, 82–94. doi:10.1016/j.ijnurstu.2016.05.014CrossRefGoogle Scholar
Statacorp (2019). Stata Statistical Software: Release 16. College Station, TX: StataCorp LLC.Google Scholar
Sundhedsdatastyrelsen (2020). Register over anvendelse af tvang i psykiatrien [Register on the use of coercion in psychiatry]. Retrieved from https://www.esundhed.dk/Dokumentation/DocumentationExtended?id=27.Google Scholar
Thomsen, C., Starkopf, L., Hastrup, L. H., Andersen, P. K., Nordentoft, M., & Benros, M. E. (2017). Risk factors of coercion among psychiatric inpatients: A nationwide register-based cohort study. Social Psychiatry and Psychiatric Epidemiology, 52, 979–987. doi:10.1007/s00127-017-1363-3CrossRefGoogle ScholarPubMed
Tingleff, E. B., Bradley, S. K., Gildberg, F. A., Munksgaard, G., & Hounsgaard, L. (2017). ‘Treat me with respect’. A systematic review and thematic analysis of psychiatric patients’ reported perceptions of the situations associated with the process of coercion. Journal of Psychiatric and Mental Health Nursing, 24, 681–698. doi:10.1111/jpm.12410CrossRefGoogle Scholar
Wallier, J., Vibert, S., Berthoz, S., Huas, C., Hubert, T., & Godart, N. (2009). Dropout from inpatient treatment for anorexia nervosa: Critical review of the literature. International Journal of Eating Disorders, 42(7), 636–647. doi:10.1002/eat.20609CrossRefGoogle ScholarPubMed
Watson, T. L., Bowers, W. A., & Andersen, A. E. (2000). Involuntary treatment of eating disorders. American Journal of Psychiatry, 157, 1806–1810. doi:10.1176/appi.ajp.157.11.1806CrossRefGoogle ScholarPubMed
Westmoreland, P., Krantz, M. J., & Mehler, P. S. (2016). Medical complications of anorexia nervosa and bulimia. American Journal of Medicine, 129, 30–37. doi:10.1016/j.amjmed.2015.06.031CrossRefGoogle ScholarPubMed
Wonderlich, S. A., Bulik, C. M., Schmidt, U., Steiger, H., & Hoek, H. W. (2020). Severe and enduring anorexia nervosa: Update and observations about the current clinical reality. International Journal of Eating Disorders, 53(8), 1303–1312. doi:10.1002/eat.23283CrossRefGoogle ScholarPubMed
World Health Organization. (1992). The ICD-10 classification of mental and behavioural disorders: Clinical descriptions and diagnostic guidelines. WHO: Geneva.Google Scholar
World Medical Association. (2013). World medical association declaration of Helsinki. JAMA, 310, 2191–2194. doi:10.1001/jama.2013.281053CrossRefGoogle Scholar
Zohar-Beja, A., Latzer, Y., Adatto, R., & Gur, E. (2015). Compulsory treatment for anorexia nervosa in Israel: Clinical outcomes and compliance. International Journal of Clinical Psychiatry and Mental Health, 3, 20–30.Google Scholar