Effects of perceptual body image distortion and early weight gain on long-term outcome of adolescent anorexia nervosa.

Anorexia nervosa (AN), a severe mental disorder with an onset during adolescence, has been found to be difficult to treat. Identifying variables that predict long-term outcome may help to develop better treatment strategies. Since body image distortion and weight gain are central elements of diagnosis and treatment of AN, the current study investigated perceptual body image distortion, defined as the accuracy of evaluating one's own perceived body size in relation to the actual body size, as well as total and early weight gain during inpatient treatment as predictors for long-term outcome in a sample of 76 female adolescent AN patients. Long-term outcome was defined by physical, psychological and psychosocial adjustment using the Morgan-Russell outcome assessment schedule as well as by the mere physical outcome consisting of menses and/or BMI approximately 3 years after treatment. Perceptual body image distortion and early weight gain predicted long-term outcome (explained variance 13.3 %), but not the physical outcome alone. This study provides first evidence for an association of perceptual body image distortion with long-term outcome of adolescent anorexia nervosa and underlines the importance of sufficient early weight gain.

[A family day clinic in child psychiatry. The Dresden model--concepts and first experiences]. / Familientagesklinik in der Kinderpsychiatrie - Das Dresdner Modell - Konzept und erste Erfahrungen -

AIMS: To present a systemic family therapy approach for children with psychiatric disorders, based on multiple family therapy principles and employing video-feedback and peer review techniques. Children and their parents together attend a family day clinic for periods of between 3 and 14 weeks. METHOD: We report on conceptual and clinical work, with case examples and discussion of a pilot study. RESULTS: At 6 months follow-up there are symptomatic and behavioural improvements in 75 % of the children and 90 % of the parents. CONCLUSIONS: Active involvement of parents in the therapy of their children appears to lead to better and longer lasting treatment results. Extensive interdisciplinary work between adult and child psychiatric services is needed, particularly with the more severe spectrum of parental psychiatric disorders.