Data_Sheet_1_Measuring Clinical Efficacy Through the Lens of Audit Data in Different Adult Eating Disorder Treatment Programmes.docx

Background: Audit data is important in creating a clear picture of clinical reality in clinical services, and evaluating treatment outcomes. This paper explored the data from an audit of a large national eating disorder (ED) service and evaluated the outcome of inpatient and day treatment programmes for patients with anorexia nervosa (AN) with and without autistic traits.Methods: Four hundred and seventy-six patients receiving treatment for AN at inpatient (IP), day-care (DC) and step-up (SU) programmes were assessed at admission and at discharge on the following measures: autistic traits, body-mass-index (BMI), ED symptoms, depression and anxiety symptoms, work and social functioning, and motivation for change. Outcomes were analyzed first at a within-group level based on change in mean scores and then at an individual level based on the clinical significance of improvement in eating disorder symptoms. Outcomes were compared between patients with high autistic traits (HAT) and low autistic traits (LAT) in each programme.Results: The findings suggest that 45.5% of DC and 35.1% of IP patients showed clinically significant changes in ED symptoms following treatment. Co-occurring high autistic traits positively predicted improvement in ED symptoms in IP setting, but was a negative predictor in DC. In IP, more HAT inpatients no longer met the BMI cut-off for AN compared to LAT peers. In terms of general psychopathology, patients with AN and HAT exhibited more severe depression symptoms, anxiety symptoms and social functioning impairment than their LAT peers, and these symptoms stayed clinically severe after treatment.Conclusions: Patients with AN and hight autistic traits are more likely than their peers with low autistic traits to show weight restoration and improvement in ED systems after inpatient treatment. This reverses in DC, with high autistic trait patients less likely to improve after treatment compared to low autistic trait patients. Our results suggest that inpatient treatment with individualized and structured routine care may be an effective model of treatment for patients with AN and high autistic traits.

背景：审计数据对于描绘临床服务的临床现实并评估治疗效果至关重要。本研究探讨了全国大型进食障碍（ED）服务审计中的数据，并评估了患有神经性厌食症（AN）的住院和日间治疗计划的疗效，无论患者是否具有自闭症特质。方法：对在住院（IP）、日间护理（DC）和升级（SU）计划中接受治疗的476名AN患者进行了评估，评估内容涵盖入院和出院时的以下指标：自闭症特质、体质指数（BMI）、进食障碍症状、抑郁和焦虑症状、工作和社交功能以及改变动机。首先，在组内层面基于平均分数的变化对结果进行了分析，然后基于进食障碍症状改善的临床意义在个体层面进行了分析。结果比较了每个计划中具有高自闭症特质（HAT）和低自闭症特质（LAT）的患者。结果：研究发现，45.5%的DC患者和35.1%的IP患者在接受治疗后表现出进食障碍症状的显著临床变化。共存的高自闭症特质在IP环境中正向预测进食障碍症状的改善，但在DC中则成为负向预测因素。在IP中，与LAT患者相比，更多HAT住院患者不再符合AN的BMI截止值。在一般心理病理学方面，患有AN和HAT的患者比他们的LAT同伴表现出更严重的抑郁症状、焦虑症状和社会功能损害，并且这些症状在治疗后仍然处于临床严重水平。结论：与低自闭症特质的患者相比，患有AN和高自闭症特质的患者在接受住院治疗后更有可能表现出体重恢复和进食障碍系统的改善。这一趋势在DC中逆转，高自闭症特质患者在治疗后改善的可能性低于低自闭症特质患者。我们的结果表明，针对患有AN和高自闭症特质的患者，个体化和结构化的常规护理的住院治疗可能是一种有效的治疗方案。