Citation

Blikshavn T, Halvorsen I, Rø. J. Eat. Disord. 2020; 8: e20.

Copyright

(Copyright © 2020, Holtzbrinck Springer Nature Publishing Group -BMC)

DOI

10.1186/s40337-020-00297-1

PMID

32514349

PMCID

PMC7262758

Abstract

BACKGROUND: Studies of the use and effects of physical restraint in anorexia nervosa (AN) treatment are lacking. The purpose of this study was to describe the frequency of physical restraint in a specialized program for adolescents with AN, and to examine if meal-related physical restraint (forced nasogastric tube-feeding) was related to 5-year outcome.
METHOD: Thirty-eight (66% of 58) patients with AN (mean age 15.9, SD = 1.9) admitted to a regional, specialized adolescent eating disorders (ED) inpatient unit. Patient data, including restraint episodes, were obtained from hospital records, and outcome was assessed at a 5-year follow-up.
RESULTS: A total of 201 restraint episodes occurred over 5513 days of inpatient treatment, including 109 meal-related episodes and 56 episodes to avoid self-harm. Twelve (32%) patients experienced at least one restraint episode during the admission, of which eight (21%) experienced meal-related restraint. Four patients represented 91% of all restraint episodes, experiencing 10 or more episodes during admission. Meal-related restraint was significantly associated with a higher rate of persisting ED diagnosis, but not with weight gain during admission, EDE-Q global score or BMI at follow-up.
CONCLUSIONS: Restraint episodes occurred rather infrequently. A small number of patients (n = 4) accounted for a high proportion of episodes (91%). More knowledge is important to reduce the need for restraint in treatment for AN.

Language: en

Keywords

Adolescent; Eating disorders; Anorexia nervosa; Physical restraint; Forced nasogastric tube feeding