Predictors of Stepping Up to Higher Level of Care Among Eating Disorder Patients in a Partial Hospitalization Program

Partial hospitalization programming (PHP) is a treatment option available for individuals with eating disorders (ED) who have made insufficient progress in outpatient settings or are behaviorally or medically unstable. Research demonstrates that this level of care yields efficacy for the majority of...

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Main Authors: Courtney C. Simpson, Terra L. Towne, Anna M. Karam, Joseph M. Donahue, Carly F. Hadjeasgari, Roxanne Rockwell, Walter H. Kaye
Format: Article
Language:English
Published: Frontiers Media S.A. 2021-07-01
Series:Frontiers in Psychology
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fpsyg.2021.667868/full
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author Courtney C. Simpson
Terra L. Towne
Anna M. Karam
Joseph M. Donahue
Carly F. Hadjeasgari
Roxanne Rockwell
Walter H. Kaye
author_facet Courtney C. Simpson
Terra L. Towne
Anna M. Karam
Joseph M. Donahue
Carly F. Hadjeasgari
Roxanne Rockwell
Walter H. Kaye
author_sort Courtney C. Simpson
collection DOAJ
description Partial hospitalization programming (PHP) is a treatment option available for individuals with eating disorders (ED) who have made insufficient progress in outpatient settings or are behaviorally or medically unstable. Research demonstrates that this level of care yields efficacy for the majority of patients. However, not all patients achieve recovery in PHP and later admit to a higher level of care (HLOC) including residential treatment or inpatient hospitalization. Although PHP is an increasingly common treatment choice for ED, research concerning outcome predictors in outpatient, stepped levels of care remains limited. Thus, the current study sought to identify the predictors of patients first admitted to PHP that later enter residential or inpatient treatment. Participants were 788 patients (after exclusions) enrolled in adolescent or adult partial hospitalization programs in a specialized ED clinic. When compared to patients who maintained treatment in PHP, a significantly greater proportion of patients who discharged to a HLOC had previously received ED residential treatment. Moreover, patients who discharged to a HLOC were diagnosed with a comorbid anxiety disorder and reported greater anxious and depressive symptomatology. A logistic regression model predicting discharge from PHP to a HLOC was significant, and lower body mass index (BMI) was a significant predictor of necessitating a HLOC. Supplemental programming in partial hospitalization settings might benefit individuals with previous ED residential treatment experience, higher levels of anxiety and depression, and lower BMIs. Specialized intervention for these cases is both practically and economically advantageous, as it might reduce the risk of rehospitalization and at-risk patients needing to step up to a HLOC.
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spelling doaj.art-1f5441c37adf45b4bf5c769c7eb9766e2022-12-21T18:22:19ZengFrontiers Media S.A.Frontiers in Psychology1664-10782021-07-011210.3389/fpsyg.2021.667868667868Predictors of Stepping Up to Higher Level of Care Among Eating Disorder Patients in a Partial Hospitalization ProgramCourtney C. SimpsonTerra L. TowneAnna M. KaramJoseph M. DonahueCarly F. HadjeasgariRoxanne RockwellWalter H. KayePartial hospitalization programming (PHP) is a treatment option available for individuals with eating disorders (ED) who have made insufficient progress in outpatient settings or are behaviorally or medically unstable. Research demonstrates that this level of care yields efficacy for the majority of patients. However, not all patients achieve recovery in PHP and later admit to a higher level of care (HLOC) including residential treatment or inpatient hospitalization. Although PHP is an increasingly common treatment choice for ED, research concerning outcome predictors in outpatient, stepped levels of care remains limited. Thus, the current study sought to identify the predictors of patients first admitted to PHP that later enter residential or inpatient treatment. Participants were 788 patients (after exclusions) enrolled in adolescent or adult partial hospitalization programs in a specialized ED clinic. When compared to patients who maintained treatment in PHP, a significantly greater proportion of patients who discharged to a HLOC had previously received ED residential treatment. Moreover, patients who discharged to a HLOC were diagnosed with a comorbid anxiety disorder and reported greater anxious and depressive symptomatology. A logistic regression model predicting discharge from PHP to a HLOC was significant, and lower body mass index (BMI) was a significant predictor of necessitating a HLOC. Supplemental programming in partial hospitalization settings might benefit individuals with previous ED residential treatment experience, higher levels of anxiety and depression, and lower BMIs. Specialized intervention for these cases is both practically and economically advantageous, as it might reduce the risk of rehospitalization and at-risk patients needing to step up to a HLOC.https://www.frontiersin.org/articles/10.3389/fpsyg.2021.667868/fullpartial hospitalizationhigher level of careeating disorderpredictorresidentialinpatient
spellingShingle Courtney C. Simpson
Terra L. Towne
Anna M. Karam
Joseph M. Donahue
Carly F. Hadjeasgari
Roxanne Rockwell
Walter H. Kaye
Predictors of Stepping Up to Higher Level of Care Among Eating Disorder Patients in a Partial Hospitalization Program
Frontiers in Psychology
partial hospitalization
higher level of care
eating disorder
predictor
residential
inpatient
title Predictors of Stepping Up to Higher Level of Care Among Eating Disorder Patients in a Partial Hospitalization Program
title_full Predictors of Stepping Up to Higher Level of Care Among Eating Disorder Patients in a Partial Hospitalization Program
title_fullStr Predictors of Stepping Up to Higher Level of Care Among Eating Disorder Patients in a Partial Hospitalization Program
title_full_unstemmed Predictors of Stepping Up to Higher Level of Care Among Eating Disorder Patients in a Partial Hospitalization Program
title_short Predictors of Stepping Up to Higher Level of Care Among Eating Disorder Patients in a Partial Hospitalization Program
title_sort predictors of stepping up to higher level of care among eating disorder patients in a partial hospitalization program
topic partial hospitalization
higher level of care
eating disorder
predictor
residential
inpatient
url https://www.frontiersin.org/articles/10.3389/fpsyg.2021.667868/full
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