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Table 1 Description and results of studies included in the review

From: A systematic review of the frequency, duration, type and effect of involuntary treatment for people with anorexia nervosa, and an analysis of patient characteristics

Study Patients/Age/N Treatment type Treatment length Admission data Discharge data Follow-up data
1. Ayton et al. [[18]] Adolescents 16 detained under section 3: 7/16 patients detained under VT, 9/16 before transfer to the clinic. IT: 14 months BMI: IT 16.6 ± 2.6, VT 14.2 ± 1.9 BMI: IT 19.6 ± 18.5 VT 18.5 ± 1.6 1 year follow-up
UK Total N = 50 Nasogastric feeding: VT: 8 months Duration of illness: IT 3.8, VT 1.9 Menstrual period: 69% vs. 17% N =41 (IT: 12/16 and VT: 29/34)
Naturalistic 3 years inclusion IT: 16 (32%) IT:69%, VT:12%   Age at onset: IT 12.5, VT 14.3 Overall ED outcome on M-R: IT 5.3 ± 3.1, VT 4 ± 2 Good outcome on weight and general functioning: IT 50%, VT 37.9%
VT (parental consent): 34 (68%)    Purging type: IT 6%, VT 15% HONOSCA: IT-28.1 ± 10.4, VT-18.3 ± 7.2 Readmissions:
    HONOSCA: IT 41.5 ± 4.8, VT 32 ± 5.0 CGAS: IT 47.2 ± 17.0, VT 36.6 ± 15.7 IT 16.7%, VT 34.5%
    Depression: IT 94%, VT 59% CGAS: IT 13 ± 6.5, VT 27 ± 9.0   Deaths: IT =0, VT =2
    Preadmissions: IT 88%, VT 29%   
    Low IQ: IT 19%, VT 3%   
    Abuse: IT 44%, VT 12%   
    Self-harm: IT 75%, VT 12%   
2. Carney et al. [[19]-[21]] Adults and adolescents. Guardianship or mental health committal. Some tube feeding (46% vs. 16%). Locked ward (42% vs. 1%) Otherwise not defined. IT: 52 days BMI: IT 13.2 ± 1.7, VT 14.03 ± 1.8 BMI: IT 14.9 ± 1.4, VT 15.4 ± 2.3  
Australia Total N = 70   VT: 47 days Purging type: IT 23%, VT 33% Weight gain: IT 5.0 ± 6.6, VT 3.7 ± 5.3  
Naturalistic 5 years inclusion 70 patients with 96 admissions.   Mean: 49 days. Preadmissions: IT 3.9 ± 3.4, VT 1.7 ± 2.3,   
IT: 23 (33%)   40% <3 weeks. Psychiatric comorbidity: IT 2 ± 1.6, VT 1 ± 0.9   
VT: 47 (67%)      
3. Griffiths et al. [[14]] , Australia Age 16–44 years Guardianship. IT: 15 weeks BMI: IT 13.41 ± 1.76, VT 14.3 ± 2.2 BMI: IT 18.05 ± 2.14, VT 17.2 ± 2.9 3 of 15 IT patients reached at follow-up – 1 of 15 died, 4 not located.
Naturalistic, Total N = 88 Otherwise not defined. VT: 9 weeks Binge/purge type: IT 60%, VT 43% Weight gain: IT 10 kg, VT 8.7  
IT cases from 4 units compared to VT IT: 15 (17%)    Residence - metropolitan: IT 67%, VT 50% Reached target weight: IT 26.7%, VT 42%  
from one of the units. VT: 73 (83%)    SES: IT 40%, VT 11%  
4. Kondo et al. [[22]] Age 12–44 years Involuntary admission for treatment and protection. IT: 216 days BMI: IT 15.3 ± 5.1, Good outcome BMI:  
Japan Total N = 70   VT: 70 days VT 14.6 ± 8.0 IT 75%, VT 55%  
Naturalistic IT: 8 (13%)      
  VT: 62      
5. Laakman et al. [[17]] Age 16-39 Guardianship, forced feeding by tube until BMI = 17.5 Total 158 days BMI: BMI:  
Germany Total N = 25   IT: 183 days IT: 11.8 IT: 16.6  
Naturalistic, all patients from 1 unit. IT: 11 (44%)   P: 166 days P: 11.9 P: 16.7  
  Persuaded (P):   PC: 145 days PC: 14.6 PC: 17.8  
7 (28%)   VT: 98 days VT: 12.1 VT: 18.8  
Parental consent (PC): 2 (8%)      
VT: 5 (20%)      
6. Ramsay et al. [[15]] Adults 7/81 involuntary admitted, 30/81 IT: 113 days BMI: IT 14.2 ± 2.7, VT 14.3 ± 2.4), BMI: IT 18.7 ± 2.3, 5.7 years follow-up:
UK Total N = 162 Detained after voluntary admission, 35/81 detained in other hospital before transfer to unit. VT: 88 days Bingeing history: IT 41%, VT 44% VT 18.5 ± 2.0. Deaths: IT 12.7% vs. VT 2.6%
Time matched controls IT: 81 (50%) No tube-feeding or physical restraint.   Vomiting history: IT 51%, VT 44% Days to target weight (equal to treatment length: 9 out of 12 death certificates included AN
  VT: 81 (50%)    Laxative history: IT 49%, VT 49% IT 113 days, VT 88 days  
     Preadmissions: IT 3.3, VT 1.8 Childhood abuse: IT 24%, VT 10%   
     Self-harm: IT 59% vs. VT 33%   
7. Serfaty & McCluskey [[23]] Adults Involuntary admitted only Not specified Mean BMI: 12.7 Mean BMI: 18.6 Mean Follow-up time 1 year
UK Total N = 11 7/11 Nasogastric feeding.   Duration of illness 14.1 year BMI >17.5 = 27% Mean BMI: 17.9
Naturalistic cases Patients in IT only All treated involuntary      BMI >17.5 = 45.5%
8. Watson et al. [[16]] Adults Involuntary admitted. IT: 58 days BMI: IT 17.4 ± 4.7, VT 18.4 ± 4.7 Preadmissions: IT 3, VT 1.4 BMI: IT 20.5 ± 3.8, VT 20.7 ± 3.6  
USA Total N = 397   VT: 41 days IQ: IT 91, VT 98 Weight gain: IT 18.8 ± 15.9, VT 13.9 ± 14.5 pounds  
Naturalistic IT: 66 (17%)    Equal eating disorder symptoms, depression, and substance abuse. Days to restored weight: IT: 58 days  
7 years inclusion VT: 331 (83%)     VT: 41 days (Equal to treatment length)  
  1. IT = Involuntary Treatment; VT = Voluntary Treatment; BMI = Body Mass Index; HONOSCA = Health of the Nation Outcome Scale for Children and Adolescents; CGAS = Children’s Global Assessment Scale: IQ = Intelligence quotient from the WAIS-R; SES = Socioeconomic Status; M-R = Morgan – Russell scale (eating disorder psychopathology).