CoChat
Sign Up
Cited by 27Eating Disorders and BehaviorsNutrition, Health and Food BehaviorChild Nutrition and Feeding Issues

Characterizing treatment-resistant anorexia nervosa

Open access
Smith, Sarah, Woodside, D. Blake·2021·Frontiers in Psychiatry
DOI 10.3389/fpsyt.2020.542206PMC PMC7819894
Open this paper in CoChat — free accountOpen PDF

Abstract

Background:The issue of treatment resistance in eating disorder care is controversial. Prior research has identified multiple failed treatment attempts as a common criterion for severe and enduring anorexia nervosa, but little is known about patients who have multiple failed treatment attempts. This study was designed to compare the clinical and demographic characteristics of eating disorder patients with multiple, incomplete inpatient admissions to those with good outcomes. Understanding if these patient populations differ at initial admissions has implications for the prediction and characterization of inpatient eating disorder treatment resistance. Methods:This study analyzed existing data from a specialist inpatient eating disorder program at a large Canadian teaching hospital collected between 2000 and 2016. Treatment resistance was defined as two or more incomplete admissions and no complete admissions in the study period. Data were available on 37 patients who met this criteria, and 38 patients who had completed their first admission and remained well (defined as a BMI > 18.5 with no binging or purging behavior) 1 year after discharge. Variables of interest included age, weight, diagnoses, duration of illness, eating disorder psychopathology, eating disorder behavioral frequencies and depressive symptoms at the time of index inpatient admissions. Statistical analyses consisted of Mann–Whitney U tests, Chi-square tests, and a logistic regression. Results:In our main bivariate analyses, patients with multiple incomplete admissions were characterized by more severe eating disorder psychopathology and depressive symptoms at admission as well as an increased prevalence of the binge purge subtype of anorexia nervosa. In our exploratory multivariate analyses controlling for diagnostic subtype and depressive symptoms, severity of eating disorder psychopathology did not remain significant. No statistically significant difference in body mass index (BMI) or frequencies of eating disorder behaviors were found. A trend toward a longer duration of illness did not meet statistical significance. Conclusions:This study found that patients considered resistant to inpatient eating disorder treatment differ from those with good outcomes at initial admission. These results suggest that while treatment-resistant anorexia nervosa may be related to severe and enduring anorexia nervosa, it may also be a different concept that warrants additional research.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.3389/fpsyt.2020.542206

Cites

27 of 28 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Conceptions of treatment resistance do not distinguish between patients who elect to end treatment for reasons pertaining to the treatment itself and those who ended treatment early due to financial constraints, work and family responsibilities, or because the treatment provider prematurely ended care.

    “Critically, conceptions of treatment resistance also do not distinguish between patients who elect to end treatment for reasons pertaining to the treatment itself and those who ended treatment early due to financial constraints (e.g., inadequate insurance), work and family responsibilities (e.g., lack of childcare or risk of job loss), or because the treatment provider prematurely ended care (e.g.”

    From Assisted death in eating disorders: a systematic review of cases and clinical rationales (2024) · cites this paper as [125]

    The Introduction (Research Question and Hypotheses; page unavailable) defines treatment resistance by multiple incomplete admissions, without specifying why treatment ended. The Methods (Intervention; page unavailable) say either patients or staff could end treatment early, but the paper does not identify financial constraints, work or family responsibilities, or treatment-related reasons for patients’ decisions. It therefore supports the concern about an outcome-based definition, but not the specific reasons listed. (LLM, conf=0.85)

    Experimental — accuracy not yet measured

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

Cited by

Sorted by citations

Related

Authors
Smith, S., & Woodside, D. B.
Affiliations
  • University of Toronto (CA)
  • University Health Network (CA)
Corresponding author
Smith, Sarah
ORCID
Venue
Frontiers in Psychiatry
Publisher
Frontiers Media SA
Published
2021-01-08
Volume
11
Pages
542206-542206
ISSN
1664-0640 (ISSN-L)
DOI
10.3389/fpsyt.2020.542206
PMC
PMC7819894
OpenAlex
W3120860339
Cited by
27
References
28
Citations by year
2026: 3 · 2025: 1 · 2024: 14 · 2023: 6 · 2022: 2 · 2021: 1
FWCI
3.92
Type
journal article
Language
en
Open access
Licence
Locations
  • Frontiers in Psychiatry (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
  • Health Sciences › Nursing › Nutrition and Dietetics › Nutrition, Health and Food Behavior
  • Health Sciences › Medicine › Psychiatry and Mental health › Child Nutrition and Feeding Issues
Keywords
anorexia nervosa, treatment resistance, eating disorder psychopathology, depressive symptoms, disease duration, body mass index, eating disorder behaviors, treatment outcome prediction

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review