Personality dimensions and treatment drop-outs among eating disorder patients treated with cognitive behavior therapy

Premature, unilateral interruption of inpatient treatment of eating disorders (ED) is a key factor limiting success. We evaluated the role of personality dimensions (temperament and character) in predicting drop-out in 145 consecutive ED inpatients (133 females) who entered cognitive behavior therapy. Baseline assessment included anthropometry, the Eating Disorder Examination, the Beck Depression Inventory, the State-Trait Anxiety Inventory, and the Temperament and Character Inventory (TCI). Treatment was based on the new transdiagnostic cognitive behavior theory of ED, adapted for an inpatient setting; it was manual-based and lasted 20 weeks (13, inpatients; 7, residential day hospital). Thirty-four patients (23.4%) discontinued treatment. Drop-outs had a lower level of education, a higher prevalence of separation or divorce in the family, and lower scores on the TCI Persistence scale. After correction for age, gender and body-mass index, scores on the Persistence scale continued to be significantly related to drop-out, and the association was confirmed by Kaplan-Meier analysis. Eating disorder patients with low Persistence scores are significantly less likely to complete inpatient treatment.