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Compulsory treatment in anorexia nervosa

Short-term benefits and long-term mortality

Published online by Cambridge University Press:  03 January 2018

Rosalind Ramsay ,
Anne Ward ,
Janet Treasure  and
Gerald F. M. Russell
Rosalind Ramsay*
Affiliation:
Eating Disorders Unit, The Maudsley Hospital, London
Anne Ward
Affiliation:
Psychotherapy Unit, The Maudsley Hospital, London
Janet Treasure
Affiliation:
Institute of Psychiatry, London
Gerald F. M. Russell
Affiliation:
Institute of Psychiatry, London
*
Professor Gerald Russell, Hayes Grove Priory Hospital, Prestons Road, Hayes, Kent BR2 7AS
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Abstract

Background

Anorexia nervosa is a mental disorder with a high long-term mortality. Patients are ambivalent about treatment and often avoid it. Of necessity, compulsory treatment sometimes must be considered. A report from the Mental Health Act Commission has helped to reduce previous confusion.

Aims

To identify the premorbid and clinical features that predisposed to compulsory admissions, the short-term benefits of the treatment and the long-term mortality rates (derived from the National Register)

Method

Eighty-one compulsory patients were compared with 81 voluntary patients.

Results

Predisposing factors to a compulsory admission were a history of childhood sexual or physical abuse or previous self-harm. Detained patients had more previous admissions. Detained patients gained as much weight during admission as voluntary patients, but took longer. More deaths among compulsory than voluntary patients (10/79 v. 2/78) were found 5.7 years (mean) after admission.

Conclusions

Compulsory treatment is effective in the short term. The higher long-term mortality in the detained patients is due to selection factors associated with an intractable illness.

Type
Papers
Information
The British Journal of Psychiatry , Volume 175 , Issue 2 , August 1999 , pp. 147 - 153
Copyright
Copyright © 1999 The Royal College of Psychiatrists 

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