An inpatient treatment program for anorexia nervosa patients

Inpatient treatment for anorexia nervosa can be necessary for medical, psychosocial or psychotherapeutic reasons. In general, these patients are characterized by "negative" selection characteristics (illness duration, failures of previous treatments, unfavourable natural milieu, poor motivation, etc). An inpatient treatment program, in which 145 female patients have been admitted, is described. It consists of two phases: a first "symptom directed" phase aiming at weight restoration and normalization of eating, based mostly on behavior therapy principles; in a second "problem oriented" phase, patients are oriented either towards outpatient treatment (family therapy, individual psychotherapy), or, in the majority of the described cases, to an inpatient psychotherapeutic community program. The difficulties of this approach and some outcome results at long-term follow-up are discussed.