Outcome Study
A recent outcome study documented that, at discharge, patients
of The Eating Disorder Center had reduced symptoms to a level
similar to non-patient college students. The study also showed
that all of the discharged patients who responded to a follow-up
survey had sustained their reduction in symptoms severity for
at least six months after leaving the program.
The research study was coordinated by Dr.
Pamela Bean, executive director of research at Rogers Memorial
Hospital, who presented the findings at the 32nd annual meeting
of the American Society of Addiction Medicine April 19-22, 2001,
in Los Angeles, California. The scientific manuscript also manuscript
also has been accepted for publication in a peer review journal,
Eating and Weight Disorders.
The study group consisted of 106 female eating
disordered patients treated at the center from August 1998 to
April 2000, with a diagnosis breakdown of 52 anorexic, 47 bulimic
and seven binge eating disordered patients. The group’s
treatment results are outlined in the accompanying graph. The
study calculated the mean scores for the eight subscales of the
Eating Disorder Inventory, a standard tool for measuring the depth
of symptoms severity. The EDI consists of 64 items that generate
8 subscale scores. The higher the subscale score, the greater
the symptom severity. The results of the study indicate a reduction
of symptoms severity at discharge compared to admission. It also
illustrates that the program is effective because at discharge
female residents have symptoms similar to the non-patient female
college sample used as a control. To demonstrate treatment effectiveness,
the resident’s scores must lie between the mean ±
1 standard deviation (SD) of the control non-patient sample. All
subscales were within the one standard deviation of the control
sample, further showing the symptoms are similar for both groups
and the treatment program is effective.
The Eating Disorder Center also has implemented
a follow-up schedule to collect data from its patients at six
months and 12 months after discharge. The EDI is mailed to the
outpatient counselor’s office. Each patient is to complete
the test at the counselor’s office and the office returns
the test to Rogers Memorial for analysis. To date, 25 females
have completed and returned the EDI. The analysis of their responses
was compared to the EDI scores obtained for the same group at
discharge; the results show that improvements in symptoms severity
remain at the six months follow-up.
Characteristics of Rogers Memorial Eating
Disorder Center (EDC) patient population:
The average age of the EDC patients is 24.2 ± 9.5 years
of age with a median of 21.0 years and a range of 13 to 54 years.
The average length of stay is 60 days ± 40 days with a
median of 51 days and a range of 4 days to 177 days. Common comorbid
conditions included depression, amenorrhea, anxiety, and alcohol,
nicotine and drug dependence.
Characteristics of the female college control
group
The mean values for the female college (FC1) control group were
obtained from the EDI manual (Garner, 1990). The FC1 sample consisted
primarily of first and second year students attending Michigan
State University between 18 and 25 years of age.
Eating Disorder Inventory Subscales
• Drive for thinness (DT): Excessive
concern with dieting, preoccupation with weight and fear of weight
gain.
• Bulimia (B): Binge eating followed
by purging through vomiting, laxative or diuretic abuse, fasting
or excessive exercise.
• Body dissatisfaction (BD): Dissatisfaction
with the overall shape and size of certain body regions, such
as stomach, hips, thighs, buttocks.
• Ineffectiveness (I): High score on
this subscale reflects a significant deficit in self-esteem due
to feelings of inadequacy.
• Perfectionism (P): Belief that only
the highest standards of personal performance are acceptable and
that outstanding achievement is expected by others (e.g., parents,
teachers).
• Interpersonal distrust (ID): General
feelings of alienation and reluctance to form close relationships.
It also measures the person’s reluctance to express thoughts
or feelings to others.
• Interoceptive awareness (IA): Taps
uncertainty in the identification of certain visceral sensations
related to hunger and satiety.
• Maturity fears (MF): Desire to retreat
to the security of childhood; starvation results in a return to
a prepubertal appearance and hormonal status.
The greatest statistically significant improvements
for patients with anorexia and patients with bulimia were obtained
in the subscales of drive for thinness, bulimia, ineffectiveness
and interoceptive awareness.
These positive results validate the treatment
approach of the Eating Disorder Center, which is focused on providing
external management of eating disorders symptoms while actively
engaging a patient in his or her treatment. Since opening in 1995,
the center’s treatment team has provided the guidance and
support needed for patients with severe and chronic eating disorders
to confront their disorder and learn to use newly acquired coping
and self-care skills. The center treats an average of 200 patients
each year, 178 women and 22 men, with separate programming for
each gender.
The Eating Disorder Center at Rogers
Memorial Hospital provides residential care as clinically intensive
as inpatient yet at a cost that is approximately one-third the
daily cost of the average inpatient program. Admissions are accepted
24 hours a day, seven days a week. For more information about
the program or to schedule a free, confidential assessment, please
call Admissions at 1-800-767-4411 ext. 340.
