Abstract
Objective: Lack of participation in follow-ups is thought to be a serious bias in outcome research on eating disorders; however, little systematic knowledge exists about the problem. The present study aimed to delineate non-participation in long-term follow-up research, and explore the reasons for non-participation. Method: Eating disorder patients (N=840) entering a naturalistic, longitudinal multi-centre study were divided into participators (N=508) and non-participators (N=332) in 36-month follow-ups. Non-participators were further classified as either active (i.e. refused participation or failed to attend scheduled appointments) or passive non-participators (i.e. could not be traced). Results: Active nonparticipators exhibited significantly lower levels of general and eating disorder psychopathology at intake compared to participators, while passive non-participators reported higher levels of hostility. Discussion: Systematic exploration of non-participation in longitudinal research can help to mitigate the problem of indistinct results due to missing data. Barriers to successful longitudinal research and how to overcome non-participation at endpoint are discussed.
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References
Lyons J.S., et al.: The Measurement and Management of Clinical Outcomes in Mental Health. New York, Wiley, 1997.
Ross S., et al.: Factors that limit the number, progress and quality of randomised controlled trials: A systematic review. In: Stevens A., et al., (Eds.), The advanced handbook of methods in evidence-based healthcare, 2001, London. SAGE. Publications Ltd., p. 38–55.
Quadflieg N., Fichter M.M.: The course and outcome of bulimia nervosa. Eur. Child Adolesc. Psychiatry, 12, 99–109, 2003.
Clausen L.: Review of studies evaluating psychotherapy in bulimia nervosa: the influence of research methods. Scand. J. Psychol., 45, 247–252, 2004.
Pike K.M.: Long-term course of anorexia nervosa: response, relapse, remission, and recovery. Clin. Psychol. Rev., 18, 447–475, 1998.
Steinhausen H.C.: The outcome of anorexia nervosa in the 20th century. Am. J. Psychiatry, 159, 1284–1293, 2002.
Fichter M.M., Quadlfieg N.: Prediction of Long-term Course and Outcome of Binge-eating Disorder (BED). Presented at the 9th General Meeting of the European Council on Eating Disorders, Austria, 2005.
Tanaka H., Kiriike N., Nagata T., Riku K.: Outcome of severe anorexia nervosa patients receiving inpatient treatment in Japan: an 8-year follow-up study. Psychiatry Clin. Neurosci., 55, 389–396, 2001.
Blouin J., Scharre K., Carter J., Blouin A., Tener L., Zuro C., Barlow J.: Factors affecting dropout rate from cognitive-behavioral group treatment for bulimia nervosa. Int. J. Eat. Disord., 17, 323–329, 1995.
Theander S.: Långtidsförloppet vid anorexia nervosa. Svensk psykiatri, 11, 13–25, 1985.
Clinton D.N.: Why Do Eating Disorder Patients Drop Out? Psychother. Psychosom., 65, 29–35, 1996.
Mahon J.: Dropping out from psychological treatment for eating disorders: What are the issues? Eur. Eat. Disord. Rev., 8, 198–216, 2000.
Steel Z., Jones J., Adcock S., Clancy R., Bridgford- West L., Austin J.: Why the high rate of dropout from individualized cognitive-behaviour therapy for bulimia nervosa? Int. J. Eat. Disord., 28, 209–214, 2000.
Waller G.: Drop-out and failure to engage in individual outpatient cognitive behaviour therapy for bulimic disorders. Int. J. Eat. Disord., 22, 35–41, 1997.
Vandereycken W., Pierloot R.: Drop-out during inpatient treatment of anorexia nervosa: A clinical study of 133 patients. Br. J. Med. Psychol., 56, 145–156, 1983.
Nielsen S.: Epidemiology and mortality of eating disorders. Psychiatr. Clin. North Am., 24, 201–214, 2001.
Kirkwood B.R., Sterne J.A.C.: Essential Medical Statistics. 2nd ed. Oxford, Blackwell Science Ltd., 2003.
Altman D.G.: Practical statistics for medical research. Statistics texts. London, Chapman and Hall, xii, 611, 2003.
Steinhausen H.C., Seidel R., Winkler Metzke C.: Evaluation of treatment and intermediate and longterm outcome of adolescent eating disorders. Psychol. Med., 30, 1089–1098, 2000.
American Psychiatric Association. Diagnostic and statistical manual of mental disorders: DSM-IV. 4th ed. 1994. Washington, DC, American Psychiatric Association.
Clinton D., Norring C.: The Rating of Anorexia and Bulimia (RAB) Interview: Development and preliminary validation. Eur. Eat. Disord. Rev., 7, 362–363, 1999.
Nevonen L., Broberg A.G., Clinton D., Norring C.: A measure for the assessment of eating disorders: reliability and validity studies of the Rating of Anorexia and Bulimia interview — revised version (RAB-R). Scand. J. Psychol., 44, 303–310, 2003.
Garner D.M.: Eating Disorder Inventory-2. Professional Manual. Odessa, Fl, Psychological Assessment Resources, 1991.
Derogatis L.R., Lipman R.S., Covi L.: SCL-90: An outpatient psychiatric rating scale — preliminary report. Psychopharmacol. Bull., 9, 13–28, 1973.
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Björk, T., Clinton, D. & Norring, C. Reasons for non-participation in follow-up research on eating disorders. Eat Weight Disord 11, 147–153 (2006). https://doi.org/10.1007/BF03327560
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DOI: https://doi.org/10.1007/BF03327560