Long-term follow-up of patient-reported family functioning in eating disorders after intensive day hospital treatment.
This study examines eating disorder outcome and self-report ratings of family functioning by patients at admission to, discharge from, and 2-year follow-up after an intensive treatment program for eating disorders. The authors assess whether previously observed improvements in patient ratings of family functioning over the course of treatment persist throughout the follow-up period, and whether poorer eating disorder outcome is associated with less favorable patient ratings of family functioning at any of the measurement periods. Fifty-seven subjects were administered two scales of the Family Assessment Measure at admission to, discharge from, and 2 year after an intensive day hospital program for eating disorders. Structured interview determined eating disorder clinical outcome at each time. Patient assignment to clinical outcome group was determined by status at discharge, and group membership was maintained for the purposes of all analyses. Previously observed improvements in subject rating of family functioning were confirmed. Subjects with good clinical outcome at discharge showed continued improvement in some ratings of their family's functioning from discharge to follow-up by which point their ratings were significantly more favorable on the Self-Rating Scale than ratings by subjects with poor clinical outcome at discharge. Ratings by subjects with poor clinical outcome at discharge were not significantly changed during the 2-year follow-up period. We conclude that subject self-report ratings of family functioning appear to be associated with the presence of actively disordered eating, improve during treatment, and are maintained over the course of 2-year posttreatment. Individuals with a good clinical outcome at the end of treatment show further improvements on some ratings of family functioning between discharge and 2-year follow-up.