Objective: This study investigates baseline predictors of treatment response in patients with anorexia nervosa (AN) who received an intensive 20-week program of enhanced cognitive behavioral therapy (CBT-E). The aim was to identify demographic, clinical, and psychosocial variables that predict treatment outcomes at the end of intensive treatment-inpatient followed by day patient (EOIT) and 20-week follow-up.
Method: A prospective cohort study was conducted with 421 patients aged 16-63 years (mean age = 25.4 years) consecutively admitted for intensive CBT-E. Baseline assessments included body mass index (BMI), eating disorder psychopathology (EDE-Q), general psychopathology, and functional impairment.
Results: Of the 421 patients, 82.7% completed the treatment, and 70.6% attended the 20-week follow-up. Considering the intent-to-treat analysis, 83.2% of patients had a "good BMI outcome" and 63.3% had a "full response" and "full recovery" at EOIT. At the 20-week follow-up, 58.7% maintained a "good BMI outcome" and 51.5% remained in "full response" and "full recovery." A higher baseline BMI was a significant predictor of achieving a good BMI outcome at EOIT and follow-up. Full response at EOIT was associated with lower baseline EDE-Q scores, while at follow-up, it was predicted by higher baseline BMI, lower EDE-Q, and larger BMI and EDE-Q changes during treatment.
Conclusions: BMI and eating-disorder psychopathology are key predictors of treatment outcomes in patients with AN undergoing intensive CBT-E. These findings emphasize the importance of early weight gain and reductions in eating disorder psychopathology as treatment targets to enhance outcomes in this population.
Keywords: anorexia nervosa; cognitive behavior therapy; cohort study; full response; inpatient treatment; predictors; prospective study.
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