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Predictors of Treatment Acceptance and Completion in Anorexia Nervosa: Implications for Future Study Designs
Abstract
CONTEXT: There have been very few randomized controlled treatment studies of anorexia nervosa. OBJECTIVE: To evaluate factors leading to nonacceptance and noncompletion of treatment for 2 specific therapies and their combination in the treatment of anorexia nervosa. DESIGN: Randomized prospective study. SETTING: Weill-Cornell Medical Center, White Plains, NY; University of Minnesota, Minneapolis; and Stanford University, Stanford, Calif. Patients One hundred twenty-two patients meeting DSM-IV criteria for anorexia nervosa. INTERVENTIONS: Treatment with cognitive-behavioral therapy, fluoxetine hydrochloride, or their combination for 1 year. MAIN OUTCOME MEASURES: Dropout rate and acceptance of treatment (defined as staying in treatment at least 5 weeks). RESULTS: Of the 122 randomized cases, 21 (17%) were withdrawn; the overall dropout rate was 46% (56/122) in the remaining patients. Treatment acceptance occurred in 89 (73%) of the 122 randomized cases. Of the 41 assigned to medication alone, acceptance occurred in 23 (56%). In the other 2 groups, acceptance rate was differentiated by high and low obsessive preoccupation scores (rates of 91% and 60%, respectively). The only predictor of treatment completion was high self-esteem, which was associated with a 51% rate of treatment acceptance. CONCLUSION: Acceptance of treatment and relatively high dropout rates pose a major problem for research in the treatment of anorexia nervosa. Differing characteristics predict dropout rates and acceptance, which need to be carefully studied before comparative treatment trials are conducted.
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Metadata
- Authors
- Halmi, K. A., Agras, W. S., Crow, S., Mitchell, J., Wilson, G. T., Bryson, S. W., & Kraemer, H. C.
- Venue
- Archives of General Psychiatry
- Publisher
- American Medical Association (AMA)
- Published
- 2005-07-01
- Volume
- 62
- Issue
- 7
- Pages
- 776
- ISSN
- 0003-990X (ISSN-L)
- OpenAlex
- W2033464619
- Cited by
- 316
- References
- 4
- FWCI
- 16.16
- Type
- journal article
- Language
- en
- Open access
- closed
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