RT Journal
A1 Halmi KA, Agras W, Crow S, et al
T1 Predictors of treatment acceptance and completion in anorexia nervosa: Implications for future study designs
JF Archives of General Psychiatry
JO Archives of General Psychiatry
YR 2005
FD July 1
VO 62
IS 7
SP 776
OP 781
DO 10.1001/archpsyc.62.7.776
UL http://dx.doi.org/10.1001/archpsyc.62.7.776
AB Context 
    There have been very few randomized controlled treatment studies of anorexia nervosa.Objective 
    To evaluate factors leading to nonacceptance and noncompletion of treatment for 2 specific therapies and their combination in the treatment of anorexia nervosa.Design 
    Randomized prospective study.Setting 
    Weill-Cornell Medical Center, White Plains, NY; University of Minnesota, Minneapolis; and Stanford University, Stanford, Calif.Patients 
    One hundred twenty-two patients meeting DSM-IV criteria for anorexia nervosa.Interventions 
    Treatment with cognitive-behavioral therapy, fluoxetine hydrochloride, or their combination for 1 year.Main Outcome Measures 
    Dropout rate and acceptance of treatment (defined as staying in treatment at least 5 weeks).Results 
    Of the 122 randomized cases, 21 (17%) were withdrawn; the overall dropout rate was 46% (56/122) in the remaining patients. Treatment acceptance occurred in 89 (73%) of the 122 randomized cases. Of the 41 assigned to medication alone, acceptance occurred in 23 (56%). In the other 2 groups, acceptance rate was differentiated by high and low obsessive preoccupation scores (rates of 91% and 60%, respectively). The only predictor of treatment completion was high self-esteem, which was associated with a 51% rate of treatment acceptance.Conclusion 
    Acceptance of treatment and relatively high dropout rates pose a major problem for research in the treatment of anorexia nervosa. Differing characteristics predict dropout rates and acceptance, which need to be carefully studied before comparative treatment trials are conducted.