When Can AN Patients Be Safely Transferred for Less-Intensive Treatment?

In many managed-care systems, clinicians are under pressure to transfer anorexic inpatients to less-intensive treatment as quickly as possible. A group at Johns Hopkins University has identified prognostic factors that can be used to determine the earliest point at which an anorexic patient can be safely transferred to a day hospital program. In a retrospective study of 71 anorexic patients, William T. Howard, MD, and his co-workers found that the risk of being readmitted to intensive treatment rose with each of the following: comorbid diabetes mellitus, AN longer than 6 years, and amenorrhea for more than 3 years. Patients who gained less than 2 lb while on the inpatient unit and those who had a lower body mass index (BMI) at admission (<75% normal) and a BMI <90% of normal at transition to day hospital treatment were also at increased risk. The study was presented in May at the American Psychiatric Association meeting in Washington, D.C.