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Impact of hospitalisation on the outcome of adolescent anorexia nervosa

  • S. G. Gowers (a1), J. Weetm An (a1), A. Shore (a1), F. Hossain (a1) and R. Elvins (a1)...

Owing to the lack of controlled trials of treatment setting in adolescent anorexia nervosa, the benefits and costs of in-patient treatment are not established.


To clarify the relationship between a range of presenting features, treatment received and medium- to long-term outcome in adolescent anorexia nervosa.


A range of presenting variables were rated for 75 cases of DSM – III – R anorexia nervosa at presentation to an adolescent service, including the Morgan–Russell Global Assessment Score. Cases were followed up at 2–7 years and outcome rated according to reliable methods. Setting of treatment received was also recorded.


Two out of 75 cases had died by the time of follow-up. Adequate data for 72 enabled an outcome category to be assigned. The 21 who had received in-patient treatment had a significantly worse outcome than the 51 never admitted to hospital. Multivariate analysis suggests admission to be the major predictor of poor outcome.


The benefits and costs of admission to hospital require further investigation, ideally in a randomised-controlled trial. The negative consequences of in-patient treatment are neglected in research.

Corresponding author
Professor S. G. Gowers, Section of Adolescent Psychiatry, University of Liverpool, Academic Unit, Pine Lodge, 79 Liverpool Road, Chester CH2 1AW
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Ambrosini P. J., Metz C., Prabucki K., et al (1989) Videotape reliability of the third revised edition of the K–SADS. Journal of the American Academy of Child and Adolescent Psychiatry, 28, 723728.
Bruch H. (1974) Perils of behaviour modification in the treatment of anorexia nervosa. Journal of the American Medical Association, 230, 14191422.
Bryant-Waugh R., Knibbs J., Fosson A., et al (1988) Long-term follow up of patients with early onset anorexia nervosa. Archives of Disease in Childhood, 63, 59.
Crisp A. H., Norton K. W. R., Gowers S. G., et al (1991) A controlled study of the effect of therapies aimed at adolescent and family psychopathology in anorexia nervosa. British Journal of Psychiatry, 159, 325333.
Gowers S. G., Crisp A. H., Joughin N., et al (1991) Premenarcheal anorexia nervosa. Journal of Child Psychology & Psychiatry, 32, 515524.
Gowers S. G., Norton K. R. W., Halek C., et al (1994) Outcome of out-patient psychotherapy in a random allocation study of anorexia nervosa. International Journal of Eating Disorders, 15, 165177.
Gowers S. G., North C. D., Byram V., et al (1996) Life event precipitants of adolescent anorexia nervosa. Journal of Child Psychology and Psychiatry, 37, 469478.
Herzog W., Rathner G. & Vandereycken W. (1992) Long-term course of anorexia nervosa. A review of the literature. In The Course of Eating Disorders (ed. W. Herzog, J. Detre & W. Vandereycken), pp. 1529. Berlin: Springer Verlag.
Morgan H. G. & Hayward A. E. (1988) Clinical assessment of anorexia nervosa: the Morgan–Russell Outcome Assessment Schedule. British Journal of Psychiatry, 152, 367371.
North C. D., Gowers S. G. & Byram V. (1995) Family functioning in adolescent anorexia nervosa. British Journal of Psychiatry, 167, 673678.
Ratnasuriya R. H., Eisler I., Szmukler G. I., et al (1991) Anorexia nervosa: outcome and prognostic factors after 20 years. British Journal of Psychiatry, 158, 495502.
Russell G. F., Szmukler G. I., Dare C., et al (1987) An evaluation of family therapy in anorexia nervosa and bulimia nervosa. Archives of General Psychiatry, 44, 10471056.
Shelley R., (ed.) (1997) Anorexics on Anorexia. London: Jessica Kingsley.
Tiller J., Schmidt U. & Treasure J. (1993) Compulsory treatment for anorexia nervosa: compassion or coercion? British Journal of Psychiatry, 162, 679680.
Ward A., Troop N., Todd G., et al (1996) To change or not to change – ‘how’ is the question? British Journal of Medical Psychology, 69, 139146.
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The British Journal of Psychiatry
  • ISSN: 0007-1250
  • EISSN: 1472-1465
  • URL: /core/journals/the-british-journal-of-psychiatry
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Impact of hospitalisation on the outcome of adolescent anorexia nervosa

  • S. G. Gowers (a1), J. Weetm An (a1), A. Shore (a1), F. Hossain (a1) and R. Elvins (a1)...
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