Evaluating empirically valid and clinically meaningful change in intensive residential treatment for severe eating disorders at discharge and at a 6-month follow-up

Purpose: The present study evaluated the statistical and clinical significance of symptomatic change at discharge and after 6 months of an intensive residential treatment for patients with eating disorders (ED), and explored the individual factors that may affect therapeutic outcomes. Methods: A sample of 118 female ED patients were assessed at intake and discharge on the following dimensions: BMI, ED-specific symptoms, depressive features, and overall symptomatic distress. A subsample of 59 patients filled out the same questionnaires at a 6-month follow-up after discharge. Results: Findings evidenced statistically significant changes in all outcome measures at both discharge and follow-up. Between 30.1–38.6% of patients at discharge and 35.2–54.2% at the 6-month follow-up showed clinically significant symptomatic change; additionally, 19.8–29.1% of patients at discharge and 22.9–38.3% at follow-up improved reliably. However, 34.9–39.8% remained unchanged and 2–4.8% worsened. At the 6-month follow-up, 21.3–25.9% showed no symptomatic change and 0–3.7% had deteriorated. Unchanged and deteriorated patients had an earlier age of ED onset and were more likely to suffer a comorbid personality pathology and to be following concurrent pharmacological treatment. Conclusions: Results suggested that intensive and multimodal residential treatment may be effective for the majority of ED patients, and that therapeutic outcomes tend to improve over time. Prevention strategies should focus on early onset subjects and those with concurrent personality pathology.