Abstract
Background: The aim is to study if the determination of target weights in a clinical therapeutic contract which guides weight gain for adolescent inpatients with anorexia nervosa (AN) is based on clearly pre-defined, objective clinical elements. method: Treating psychiatrists completed patient information questionnaires for 139 anorexic adolescent inpatients. These questionnaires included information related to factors that the clinical team had hypothesized to be decisive in weight contract determination. Comparative statistical procedures evaluated whether these factors were in fact decisive in clinical practice. Results: The two weight objectives comprising our therapeutic contract (separation end weight and final discharge weight) were significantly related to the clinical variables tested: separation end weight was explained by the theoretical separation end weight, the range of contract, and the desires of the patient and her parents; final discharge weight was explained by patient body mass index before AN and by the desires of the patient and her parents. Conclusion: The therapeutic contract is based on objective criteria and implemented by our team in accordance with its theoretical design. It is therefore possible to establish goal weights in a defined and reliable manner.
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Bulik C.M., Berkman N.D., Brownley K.A., Sedway J.A., Lohr K.N.: Anorexia nervosa treatment: a systematic review of randomized controlled trials. Int. J. Eat. Disord., 40, 310–320, 2007.
Jeammet P.: Contrat et contraintes, dimension psychologique de l’hospitalisation dans le traitement de l’anorexie mentale. Psychologie Française, 29, 137–142, 1984.
Godart N., Perdereau F., Galès O., Agman G., Deborde A.S., Jeammet P.: The weight contract during the hospitalization of anorexic patients. Arch. Pédiatr., 12, 1544–1550, 2005.
Agman G., Corcos M., Jeammet P.: Troubles des conduites alimentaires. Encyclopédie Médico-Chirugicale, Psychiatrie. Paris, Editions Techniques, 1994.
Godart N., Agman G., Jeammet P.: Anorexie mentale origines et prise en charge. La Revue du Praticien Gynécologie et Obstetrique, 11, 15–17, 1997.
Sibertin-Blanc D.: Anorexia nervosa and bulimia in adolescents. Diagnosis, treatment. Revue du Praticien, 15, 2255–2264, 1996.
Doyen C., Le Heuzey M.F., Cook S., Fleho F., Mouren- Simeoni M.C.: Anorexia nervosa in children and adolescents: new therapeutic approaches. Les Archives de Pediatrie, 6, 1217–1223, 1999.
Godart N., Atger F., Perdereau F., Agman G., Rein Z., Corcos M., Jeammet P.: Treatment of adolescent patients with eating disorders: Description of a psychodynamic approach in clinical pratice. Eat. Weight Disord. 9, 224–227, 2004.
Jeammet P., Chabert C.: A psychoanalytic approach to eating disorders: the role of dependency. Adolescent Psychiatry: The Annals of the American Society for Adolescent Psychiatry, 22, 59–84, 1998.
Rolland-Cachera M.F., Cole T.J., Sempe M., Tichet J., Rossignol C., Charraud A.: Body mass index variations: centiles from birth to 87 years. Eur. J. Clin. Nutr., 45, 13–21, 1991.
Wannan G., Fombonne E.: Gender differences in rates and correlates of suicidal behaviour amongst child psychiatric outpatients. J. Adolesc., 21, 371-381.
Corcos M., Dugré-le Bigre C., Perez-Diaz F., Flament M., Jeammet P.: Présentation de l’étude de recherche clinique sur les conduites de dépendance. In: Corcos M., Flament M., Jeammet P. (Eds.), Les conduites de dépendance: dimensions psychopathologiques communes. Paris, Masson, 2003, pp. 3–21.
Golden N.H., Jacobson M.S., Schebendach J., Solanto M.V., Hertz S.M., Shenker I.R.: Resumption of menses in anorexia nervosa. Arch. Pediatr. Adolesc. Med., 151, 16–21, 1997.
Baran S.A., Weltzin T.E., Kaye W.H.: Low discharge weight and outcome in anorexia nervosa. Am. J. Psychiatry, 152, 1070–1072, 1995.
Golden N.H., Jaconson M.S., Sterling W.M., Hertz S.: Treatment goal weight in adolescents with anorexia nervosa: use of BMI percentiles. Int. J. Eat. Disord., 41, 301–306, 2008.
Pollice C., Kaye W.H., Greeno C.G., Weltzin T.E.: Relationship of depression, anxiety, and obsessionality to state of illness in anorexia nervosa. Int. J. Eat. Disord., 21, 367–376, 1997.
Godart N., Rein Z., Perdereau F., Curt F., Jeammet P.: Predictors of premature termination of anorexia nervosa treatment. Am. J. Psychiatry, 162, 2398–2399, 2005.
Lievers L.S., Curt F., Wallier J., Perdereau F., Rein Z., Jeammet P., Godart N.: Predictive factors of length of inpatient treatment in anorexia nervosa. Eur. Child Adolesc. Psychiatry, 18, 75–84, 2009.
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Godart, N., Wallier, J., Hubert, T. et al. Detemining factors for target weights in an anorexia nervosa inpatient program for adolescents and young adults: Study on the links between theory-based hypotheses and the realities of clinical practice. Eat Weight Disord 14, e176–e183 (2009). https://doi.org/10.1007/BF03325114
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DOI: https://doi.org/10.1007/BF03325114