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Paper of the Day - Anorexia best treated in community

People with anorexia nervosa who are treated as inpatients do significantly worse than those treated as outpatients or by community services, according to a review of NHS services.

Researchers at the University of Liverpool studied outcomes in 167 young people treated in one of three settings: inpatient, specialist outpatients and general child and adolescent mental health services.
Each service was associated with clinical progress at one year, though full recovery at two years was only achieved in 33% of patients, with 27% still having anorexia nervosa. But inpatient treatment was a significant predictor of poorer outcomes. Patients who were not helped by outpatient clinics or CAMHS did especially badly when transferred to inpatient care.
A seperate analysis of the cost-effectiveness of different treatment settings concluded that specialist outpatient was cheaper than general outpatient and inpatient services although treatment outcomes were similar in all three. CAMHS eating disorder services were not included.

British Journal of Psychiatry 2007 191:427-435
British Journal of Psychiatry 2007 191:436-440.

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