Læknablaðið - 01.05.2015, Blaðsíða 25

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ENgLISH SUMMArY
Objective: Treatment adherence in patients with eating disorders (ED)
in Iceland is unknown. The aim of the study was to investigate treatment
drop-out and explore factors that influence premature termination of
treatment in a specialized ED treatment unit, at the University Hospital of
Iceland, during the period of September 1, 2008 - May 1, 2012.
Material and Methods: The study is retrospective and naturalistic.
Hospital records of referred patients were examined. Those meeting the
ICD 10 criteria of anorexia nervosa (AN) (F50.0, F50.1), bulimia nervosa
(BN) (F50.2, F50.3) and eating disorder not otherwise specified (EDNoS)
(F50.9) were included. The total sample was 260 and 182 patients met
inclusion criteria. No-shows were 7%. Drop-out was defined as premat-
ure termination of treatment without formal discharge.
Results: The sample consisted of 176 women and 6 men, mean age
26.3 years. BN was diagnosed in 52.7% of patients, EDNoS in 36.8%
AN in 10.4%. 74.7% had one or more co-morbid psychiatric diagnosis.
Anxiety- and/or depression were diagnosed in 72.5%, Attention hype-
ractivity deficiency disorder in 15.4% and personality disorders in 8.2%.
Lifetime prevalence of substance use disorders (SUDs) was 30.8%.
Drop-out from treatment occurred in 54.4% of cases (with approximately
1/3 returning to treatment), 27.5% finished treatment and 18.1% were
still in treatment at the end of the follow up period. Treatment adherence
was significantly higher in patients who had a university degree, in those
who had themselves taken the initiative to seek ED treatment and in
those with higher anxiety scores at assessment. AN patients did better
than other ED patients while patients with SUDs showed a tendency for
higher drop-out (p=0.079).
Conclusion: The drop-out rates were similar to what has been reported
from other western countries. Follow-up time was longer and AN patient
did better than expected. Higher education, initiative in seeking treat-
ment and higher anxiety scores on questionnaires were protective.
Eating Disorder Treatment in iceland – Treatment adherence, psychiatric
co-morbidities and factors influencing drop-out
Gudrun Mist Gunnarsdottir1, Sigurdur Páll Pálsson2, Gudlaug Thorsteinsdottir2,3
1Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, 2Division of Psychiatry, 3Eating Disorder Unit, Landspitali – The National University Hospital of Iceland
key words: eating disorders, treatment adherence, drop-out, naturalistic study.
Correspondence: Guðlaug Þorsteinsdóttir, gudlthor@landspitali.is
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