Skip to main content

Table 6 Studies of adjunctive treatments in addition to inpatient treatment for children and adolescents with eating disorders

From: Outcomes of inpatient psychological treatments for children and adolescents with eating disorders at time of discharge: a systematic review

Author, Year

# of Participants

(Diagnosis)

Study Design

Mean Length of Intervention

Primary Outcome

Findings

Asch, 2014 [71]

2 (both AN-R)

Case reports

10 weeks

Change in weight (BMI pre/post)

Change in EAT-26 score pre/post

Change in EBRSa score pre/post

Both patients gained weight (Pt 1: BMI 15.3 to BMI 18.1, Pt 2: BMI 13.3 to BMI 17.5)

EAT-26 scores for both patients decreased over the intervention

EBRS scores for both patients decreased over the intervention

Kuge, 2017 [72]

7 (all AN)

Case reports

4 weeks

Change in weight (BMI and %TGW pre/post)

Mean weight rose over the intervention (mean BMI rose from 14.8 to 16.0, ESb 0.80 and mean %TGW rose from 73.6 to 79.4%, ES 0.68)

Harrison, 2017 [73]

70 (66 AN-R, 4 AN-B/P)

Case series

10 weeks

Change in weight (mean %TGW pre/post)

Change in EDE-Q score pre/post

Change in motivation (MSCAREDc pre/post)

Weight increased significantly during the intervention (79.3%TGW to 89.0%TGW, p < 0.001)

Non-significant decrease in EDE-Q score (p < 0.08)

Significant increase in motivational stage of change (p < 0.001)

Herbrich, 2017 [74]

48 (36 AN-R, 8 AN-B/P, 4 atypical AN)

Case control

5 weeks

Change in weight (mean BMI centile pre/post)

Significant increase in BMI centile in both groups pre/post (p < 0.006), no difference between groups

Depestele, 2017 [75]

112 (45 AN-R, 26 AN-B/P, 24 BN, 16 ED-NOS)

Case control (compared adjunctive multi-family group, n = 62 vs multi-parent group, n = 50)

8.5 weeks

Change in mean EDI-2 scores over time and between interventions

Change in frequency of B/P behaviours over time

Significant improvement in mean EDI-2 subscales of drive for thinness (p < 0.001) and body dissatisfaction (p < 0.001). No significant difference between interventions

BP behaviours decreased over time for patients with BN (p < 0.05) and AN-B/P (p < 0.01)

Janas-Kozik, 2011 [76]

24 (all AN-R)

RCT (inpatient bright light therapy + CBT,d n = 12, vs inpatient CBT alone, n = 12)

6 weeks

Mean change in weight during intervention (BMI)

At end of intervention both groups had an increase in BMI of 10%, however significant increase from baseline in bright light group evident at week 3 vs week 6 for no bright light therapy

Couturier, 2009 [77]

21 (19 AN-R, 2 AN-B/P)

Case control (patients treated with meal support, n = 12, versus no meal support, n = 9)

61.2 (SD = 37.4) vs 78.0 (SD = 46.5), NS difference (p < 0.39)

Mean weekly weight gain

Rate of need for NGTe feeds

Mean weekly weight gain did not differ between groups (1.2 kg/week +/−1.0 vs 0.6 kg/week +/−0.4, p < 0.09)

Patients receiving meal support had a significantly lower rate of NGT feeds than those without meal support (11.1% vs 66.7%, p < 0.02)

Kells, 2013 [78]

52 (restrictive ED, no specific diagnoses reported)

Case control (patients who received at least one supervised meal/admission, n = 13 vs those who received no meal support, n = 39)

8.4 (SD = 7.5) vs 5.9 (SD = 3.5), non-significant difference (p < 0.66)

Mean daily weight gain (kg)

No significant difference between groups (0.35 kg+/−0.23 kg/week vs 0.33 kg+/− 0.29 kg/week, p < 0.65)

Kells, 2016 [79]

108 (restrictive ED, no specific diagnoses reported)

Case control (patients with no meal support, n = 38 vs delayed meal support, n = 11 vs meal support, n = 54)

5.9 (SD = 3.5) vs 9.8 (SD = 7.3) vs 6.7 (SD = 3.3), non-significant difference (p < 0.27)

Mean daily weight gain (kg)

No significant difference between groups (0.34 +/−0.29 kg/d vs 0.31 +/− 0.26 kg/d vs 0.32 +/− 0.29 kg/d, p < 0.63)

Leacy, 2012 [80]

40 (38 AN-R, 2 AN-B/P)

Case control (patients treated with selective menus, n = 22, compared to non-selective menus, n = 18)

74.2 (SD = 28.7) vs 60.3 (SD = 22.8), non-significant difference (p < 0.09)

Mean weekly weight gain and change in EDE-Q scores

Patients treated with non-selective menus had a significantly higher weekly weight gain (0.95 +/− 0.35 kg/week) than those treated with selective menus (0.72 +/− 0.24 kg/week) (p < 0.02)

There was no difference in change in EDE-Q scores between groups.

  1. aEBRS Eating behaviors rating scale
  2. bES Effect size
  3. cMSCARED Motivational stages of change for adolescents recovering from an eating disorder
  4. dCBT Cognitive behavioral therapy
  5. eNGT Nasogastric tube