Inpatient treatment response and psychopathology in eating disorders

Abstract

The relationship between short-term eating disorder treatment response and general psychopathology symptoms was investigated with 85 anorexic and bulimic inpatients. Hypothesis I was that change in eating disorder symptoms would be predicted by severity of general psychopathology symptoms at admission, including sense of ineffectiveness (INEF). Hypothesis II was that improvement in eating disorder symptoms would be accompanied by improvement in general psychopathology symptoms.;Data were collected upon admission and discharge on the Eating Attitudes Test, Eating Disorders Inventory symptom subscales (EDI), the new Progress Rating Form, the Hamilton Rating Scale for Depression, Brief Psychiatric Rating Scale (BPRS), Crown-Crisp Experiential Index, and EDI Ineffectiveness subscale. Each hypothesis was tested in separate sets of stepwise multiple regression analyses.;Severity of general psychopathology symptoms at admission, including INEF, did not significantly predict residualized change in eating disorder symptoms. Variance that INEF would have accounted for was subsumed by its association with admission eating disorder scores. Results do not support Hypothesis I. At discharge, subjects as a group had changed significantly on all eating disorder and psychopathology measures. It is concluded that much of general psychopathology symptoms upon admission to inpatient eating disorder treatment appears to reflect acute secondary psychopathology rather than chronic impairment.;Amount of change in eating disorder symptoms did not significantly predict residualized change in general psychopathology symptoms, except for an association between the instruments with the broadest range of symptoms (EDI and BPRS). The majority of these results do not support Hypothesis II. Improvement in eating disorder symptoms may bear a different relationship to improvement in secondary psychopathology for different inpatient subgroups. Other methods of data analysis might uncover such relationships.;Admission severity of symptoms and length of hospital stay together accounted for one third of the variance in change in symptoms. Diagnostic subgroup was not significantly related to any change variables.;The present studies focused on disturbed attitudes to eating, weight, and shape. Results might have differed if behavioral or physical eating disorder measures had also been feasible.