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Sex differences in the effects of residential treatment on the quality of life of eating disorder patients

  • Theodore Weltzin
  • Pamela Bean
  • Eric Klosterman
  • Han-Joo Lee
  • Robyn Welk-Richards
Original Article

Abstract

Aims

This study compared the effects of residential treatment on improving health-related quality of life (HRQOL) between males and females diagnosed with eating disorders (EDs) from admission to discharge and at follow-up. This study also analyzed the association between changes in HRQOL and changes in the severity of ED pathology, depression, and trait anxiety.

Methods

145 consecutive patients (34 males and 111 females) admitted to a residential ED unit completed a panel of surveys at admission and discharge. The survey panel included the Eating Disorders Quality of Life Survey (EDQLS), the Eating Disorder Examination Questionnaire, the Quick Inventory of Depressive Symptomatology and the State-Trait Anxiety Inventory. An online follow-up survey was also conducted for the EDQLS. Mixed-factorial ANOVA was used to examine sex differences and changes in HRQOL between admission, discharge and post-treatment follow-up. Multiple regression analysis was used to investigate the relationship between sex, change in HRQOL, and changes in all other variables studied.

Results

By the end of residential treatment, both males and females had made similar statistically significant improvements in HRQOL from admission to discharge, which persisted after treatment. Greater decreases in ED pathology and trait anxiety significantly predicted greater increases in HRQOL during residential treatment while sex and changes in depression did not.

Conclusion

The data show that residential treatment is an effective approach to improving HRQOL in both males and females with EDs. Greater improvements in trait anxiety and ED pathology contributed to greater improvement in HRQOL in these patients.

Keywords

Quality of life Residential eating disorder treatment 

Notes

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

References

  1. 1.
    Brewerton TD, Costin C (2011) Treatment results of anorexia nervosa and bulimia nervosa in a residential treatment program. Eat Disord 19(2):117–131. doi: 10.1080/10640266.2011.551629 CrossRefPubMedGoogle Scholar
  2. 2.
    Delinsky SS, Thomas JJ, Germain SA, Ellison Craigen K, Weigel TJ, Levendusky PG et al (2011) Motivation to change among residential treatment patients with an eating disorder: assessment of the multidimensionality of motivation and its relation to treatment outcome. Int J Eat Disord 44(4):340–348. doi: 10.1002/eat.20809 CrossRefPubMedGoogle Scholar
  3. 3.
    McHugh MD (2007) Readiness for change and short-term outcomes of female adolescents in residential treatment for anorexia nervosa. Int J Eat Disord 40(7):602–612. doi: 10.1002/eat.20425 CrossRefPubMedGoogle Scholar
  4. 4.
    Bean P, Weltzin T (2001) Evolution of symptom severity during residential treatment of females with eating disorders. Eat Weight Disord 6(4):197–204. doi: 10.1007/BF03339743 CrossRefPubMedGoogle Scholar
  5. 5.
    Engel SG, Adair CE, Las Hayas C, Abraham S (2009) Health-related quality of life and eating disorders: a review and update. Int J Eat Disord 42(2):179–187. doi: 10.1002/eat.20602 CrossRefPubMedGoogle Scholar
  6. 6.
    The WHOQOL Group (1998) Development of the World Health Organization WHOQOL-BREF quality of life assessment. Psychol Med 28(3):551–558. doi: 10.1017/s0033291798006667 CrossRefGoogle Scholar
  7. 7.
    McHorney CA, Ware JE Jr, Raczek AE (1993) The MOS 36-Item Short-Form Health Survey (SF-36): II. Psychometric and clinical test of validity in measuring physical and mental health constructs. Med Care 31(3):247–263. doi: 10.1097/00005650-199303000-00006 CrossRefPubMedGoogle Scholar
  8. 8.
    Keilen M, Treasure T, Schmidt U, Treasure J (1994) Quality of life measurements in eating disorders, angina, and transplant candidates: are they comparable? J R Soc Med 87(8):441–444. doi: 10.1177/014107689408700804 PubMedCentralPubMedGoogle Scholar
  9. 9.
    Padierna A, Quintana JM, Arostegui I, Gonzalez N, Horcajo MJ (2002) Changes in health related quality of life among patients treated for eating disorders. Qual Life Res 11(6):545–552. doi: 10.1023/A:1016324527729 CrossRefPubMedGoogle Scholar
  10. 10.
    Noordenbos G, de la Rie SM, van Furth EF (2005) Quality of life and eating disorders. Qual Life Res 14(6):1511–1522. doi: 10.1007/s11136-005-0585-0 CrossRefPubMedGoogle Scholar
  11. 11.
    Hay PJ, Mond J (2005) How to ‘count the cost’ and measure burden? A review of health-related quality of life in people with eating disorders. J Ment Health 14(6):539–552. doi: 10.1080/09638230500400274 CrossRefGoogle Scholar
  12. 12.
    Doll HA, Peterson SE, Stewart-Brown SL (2005) Eating disorders and emotional and physical well-being: associations between student self-reports of eating disorders and quality of life as measured by the SF-36. Qual Life Res 14(3):705–717. doi: 10.1007/s11136-004-0792-0 CrossRefPubMedGoogle Scholar
  13. 13.
    Mond JM, Hay PJ, Rodgers B, Owen C, Beumont PJ (2005) Assessing quality of life in eating disorder patients. Qual Life Res 14(1):171–178. doi: 10.1007/s11136-004-2657-y CrossRefPubMedGoogle Scholar
  14. 14.
    Engel SG, Wittrock DA, Crosby RD, Wonderlich SA, Mitchell JE, Kolotkin RL (2006) Development and psychometric validation of an eating disorder-specific health-related quality of life instrument. Int J Eat Disord 39(1):62–71. doi: 10.1002/eat.20200 CrossRefPubMedGoogle Scholar
  15. 15.
    Las Hayas C, Quintana JM, Padierna A, Bilbao A, Muñoz P, Madrazo A et al (2006) The new questionnaire health-related quality of life for eating disorders showed good validity and reliability. J Clin Epidemiol 59(2):192–200CrossRefPubMedGoogle Scholar
  16. 16.
    Abraham SF, Brown T, Boyd C, Luscombe G, Russell J (2006) Quality of life: eating disorders. Aust NZJ Psychiatry 40(2):150–155. doi: 10.1080/j.1440-1614.2006.01762.x CrossRefGoogle Scholar
  17. 17.
    Adair CE, Marcoux GC, Cram BS, Ewashen CJ, Chafe J, Cassin SE et al (2007) Development and multi-site validation of a new condition-specific quality of life measure for eating disorders. Health Qual Life Outcomes 5:23. doi: 10.1186/1477-7525-5-23 PubMedCentralCrossRefPubMedGoogle Scholar
  18. 18.
    Sanftner JL (2011) Quality of life in relation to psychosocial risk variables for eating disorders in women and men. Eat Behav 12(2):136–142. doi: 10.1016/j.eatbeh.2011.01.003 CrossRefPubMedGoogle Scholar
  19. 19.
    Ríos PB, Lobera IJ (2011) Body image quality of life in eating disorders. Patient Prefer Adherence 5:109–116. doi: 10.2147/ppa.s17452 Google Scholar
  20. 20.
    Goldstein M, Peters L, Baillie A, McVeagh P, Minshall G, Fitzjames D (2011) The effectiveness of a day program for the treatment of adolescent anorexia nervosa. Int J Eat Disord 44(1):29–38. doi: 10.1002/eat.20789 CrossRefPubMedGoogle Scholar
  21. 21.
    Exterkate CC, Vriesendorp PF, de Jong C (2009) Body attitudes in patients with eating disorders at presentation and completion of intensive outpatient day treatment. Eat Behav 10(1):16–21. doi: 10.1016/j.eatbeh.2008.10.002 CrossRefPubMedGoogle Scholar
  22. 22.
    Frisch MJ, Herzog DB, Franko D (2006) Residential treatment for eating disorders. Int J Eat Disord 39(5):434–442. doi: 10.1002/eat.20255 CrossRefPubMedGoogle Scholar
  23. 23.
    Mond JM, Hay PJ, Rodgers B, Owen C, Beumont PJ (2004) Validity of the Eating Disorder Examination Questionnaire (EDE-Q) in screening for eating disorders in community samples. Behav Res Ther 42(5):551–567. doi: 10.1016/s0005-7967(03)00161-x CrossRefPubMedGoogle Scholar
  24. 24.
    Beerten R, Lynn P, Laiho J, Martin J (2001) Response rates as a measure of survey quality. In: Proceedings of NTSS & ETK 2001: new techniques and technologies for statistics: exchange of technology and know how. Crete, Greece, pp 601–607. Retrieved from http://www.websm.org/uploadi/editor/61.pdf
  25. 25.
    Adair CE, Marcoux GC, Bischoff TF, Cram BS, Ewashen CJ, Pinzon J et al (2010) Responsiveness of the Eating Disorders Quality of Life Scale (EDQLS) in a longitudinal multi-site sample. Health Qual Life Outcomes 8:83. doi: 10.1186/1477-7525-8-83 PubMedCentralCrossRefPubMedGoogle Scholar
  26. 26.
    Rush AJ, Trivedi MH, Ibrahim HM, Carmody TJ, Arnow B, Klein DN et al (2003) The 16-item Quick Inventory of Depressive Symptomatology (QIDS) clinician rating (QIDS-C) and self-report (QIDS-SR): a psychometric evaluation in patients with chronic major depression. Biol Psychiatry 54(5):573–583. doi: 10.1016/s0006-3223(02)01866-8 CrossRefPubMedGoogle Scholar
  27. 27.
    Inventory of Depressive Symptomatology (IDS) & Quick Inventory of Depressive Symptomatology (QIDS). http://www.ids-qids.org/index.html
  28. 28.
    Spielberger CD, Gorsuch RL, Lushene R, Vagg PR, Jacobs GA (1993) Manual for the state-trait anxiety inventory. Consulting Psychologists Press, Palo AltoGoogle Scholar
  29. 29.
    Luce KH, Crowther JH (1999) The reliability of the eating disorder examination—self-report questionnaire version (EDE-Q). Int J Eat Disord 25(3):349–351. doi: 10.1002/(sici)1098-108x(199904)25:3<349:aid-eat15>3.3.co;2-d CrossRefPubMedGoogle Scholar
  30. 30.
    Peterson CB, Crosby RD, Wonderlich SA, Joiner T, Crow SJ, Mitchell JE et al (2007) Psychometric properties of the eating disorder examination-questionnaire: factor structure and internal consistency. Int J Eat Disord 40(4):386–389. doi: 10.1002/eat.20373 CrossRefPubMedGoogle Scholar
  31. 31.
    Bean P, Loomis CC, Timmel P, Hallinan P, Moore S, Mammel J et al (2004) Outcome variables for anorexic males and females one year after discharge from residential treatment. J Addict Dis 23(2):83–94. doi: 10.1300/j069v23n02_06 CrossRefPubMedGoogle Scholar
  32. 32.
    Bean P, Welk R, Hallinan P, Cornella-Carlson T, Weisensel N, Weltzin T (2008) The effects of a multidisciplinary approach to treatment in the recovery of males and females diagnosed with anorexia nervosa in the presence and absence of co-morbid obsessive compulsive disorders. J Groups Addict Recover 3(3–4):305–321. doi: 10.1080/15560350802424969 CrossRefGoogle Scholar
  33. 33.
    Lavender JM, De Young KP, Anderson DA (2010) Eating Disorder Examination Questionnaire (EDE-Q): norms for undergraduate men. Eat Behav 11(2):119–121. doi: 10.1016/j.eatbeh.2009.09.005 CrossRefPubMedGoogle Scholar
  34. 34.
    Public Works and Government Services Canada (2007) Best practices in public opinion research: Improving respondent cooperation for telephone surveys. http://www.tpsgc-pwgsc.gc.ca/rop-por/rapports-reports/telephone/tdm-toc-eng.html. Accessed 21 July 2014
  35. 35.
    Leung SF, Ma JL, Russell J (2013) Enhancing quality of life in people with disordered eating using an online self-help programme. J Eat Disord 1:9. doi: 10.1186/2050-2974-1-9 PubMedCentralCrossRefPubMedGoogle Scholar
  36. 36.
    Bamford B, Sly R (2010) Exploring quality of life in the eating disorders. Eur Eat Disord Rev 18(2):147–153. doi: 10.1002/erv.975 CrossRefPubMedGoogle Scholar
  37. 37.
    Centers for Disease Control and Prevention (2011) Assessing your weight: about adult BMI. http://www.cdc.gov/healthyweight/assessing/bmi/adult_bmi/index.html. Accessed 24 July 2013

Copyright information

© Springer International Publishing Switzerland 2014

Authors and Affiliations

  • Theodore Weltzin
    • 1
  • Pamela Bean
    • 2
  • Eric Klosterman
    • 2
  • Han-Joo Lee
    • 3
  • Robyn Welk-Richards
    • 1
  1. 1.Eating Disorder CenterRogers Memorial HospitalOconomowocUSA
  2. 2.Outcome StudiesRogers Memorial HospitalOconomowocUSA
  3. 3.Department of PsychologyUniversity of Wisconsin–MilwaukeeMilwaukeeUSA

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