How effective is outpatient care compared to inpatient care for the treatment of anorexia nervosa? A systematic review

Objective: To review systematically inpatient compared to outpatient care f or the treatment of anorexia nervosa and other eating disorders. Method: Search of electronic databases, references and contact with experts to identify randomized controlled trials (RCTs), case-control studies and case series, Study quality was assessed and data extracted by two independe nt researcher. Results: Two RCTs and seven case series were identified. Unpublished 5-year follow-up data from one RCT showed a (non-statistically significant) impro vement in percentage well in the outpatient compared to the inpatient group , but no difference in mortality. Case series were difficult to interpret b ecause of the inherent biases - follow-up varied from 1.5 to 11.7 years and showed wide variations in outcome. Discussion: There is no evidence that inpatient treatment is more (or less) effective than outpatient treatment for people with anorexia nervosa in th e long term. Short-term emergency inpatient treatment of the consequences o f eating disorders may still be necessary. Copyright (C) 2001 John Wiley & Sons, Ltd and Eating Disorders Association.