Prediction of failure of inpatient treatment of anorexia nervosa from early weight gain

Anorexia nervosa is difficult to treat. It is important to identify patients at risk for failure early in the treatment process. Eighty-five consecutively admitted inpatients (DSM IV) were treated with an integrative approach including a treatment contract. Failure at discharge was defined as leaving with a BMI of less than 17.5 kg/m2 or gaining <2 kg/m2 in weight. Statistical analysis consisted of growth curve analysis, methods of regression with optimal scaling and ROC-curves. Twenty percent of patients were rated as ‘failures’. Parameters of weight curves of week 3 and 4 predicted outcome at an effectiveness of p=0.84. Thirty percent of the patients were classified as ‘at-risk-of-failure’ and 82.4% of these were identified correctly. Known predictors of the long term course did not predict outcome status at discharge. Characteristics of the weight gain curve (first four weeks of treatment) allowed identification of a substantial proportion of patients at risk for failure.