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Curr Opin Psychiatry. 2008 Sep;21(5):495-8. doi: 10.1097/YCO.0b013e328305e45c.

Forced treatment of patients with anorexia.

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1
Department of Social Studies, University of Applied Sciences Bielefeld, Germany. cornelia.thiels@fh-bielefeld.de

Abstract

PURPOSE OF REVIEW:

To consider clinical, ethical and legal approaches to forced feeding in patients with anorexia nervosa in the light of recent literature.

RECENT FINDINGS:

An Australian retrospective record analysis compared 27 coercive with 96 informal hospitalizations and found more previous inpatient treatments, comorbidities, and a lower BMI at admission of 13.2 (SD 1.67) kg/m, but no significantly different weight gain [4.96 (SD 6.56) kg]. In a higher proportion of the involuntary group a re-feeding syndrome, treatment in a locked ward, and tube feeding were recorded. In Germany 25 women with anorexia nervosa with an admission BMI of 12.09 (SD 1.51) kg/m gained 12.44 (SD 1.21) kg. Twenty were treated involuntarily and 22 received tube feeding- 20 of whom were fed a via transdermal duodenal tube, four of whom as voluntary patients.

SUMMARY:

As full recovery is possible in life-threatening anorexia nervosa, detention is sometimes justifiable and may indeed be necessary. Compulsory admission, however, does not necessarily imply a need for forced or tube feeding. Highly skilled nursing seems preferable, and so it may be better to admit the patient before the BMI drops below 13 kg/m. The validity of this proposal should be examined using a prospective research design with a follow-up period.

PMID:
18650694
DOI:
10.1097/YCO.0b013e328305e45c
[Indexed for MEDLINE]
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