A systematic review 1 including one RCT with a total of 90 subjects, four case control studies (number of participants not stated), and seven follow-up case series studies (number of participants unclear) was abstracted in DARE.
The evidence from the single RCT with available data suggests that for the group of people with anorexia nervosa, which is severe enough to consider inpatient care, but not severe enough for this to be essential, outpatient treatment is at least as effective as inpatient treatment. Further, the findings are suggestive of better outcomes for the outpatient groups.
The benefits of outpatient and inpatient treatment appear to increase over time.
The results from the case-control studies and audit suggest that, in normal practice, those admitted as in-patients have, on average, a lower weight than those not admitted. There are few other differences between those normally treated as inpatients compared with those normally treated as outpatients, particularly for psychological factors.
The results from the case series show a wide variety of mortality and percentage well outcomes. This means that drawing conclusions from these case series as a whole is not possible.
Comment: The quality of evidence is downgraded bystudy limitations, inconsistency of results, and sparse data. The authors state that the RCT was not blinded and the difficulties in carrying it out means that the results must be viewed with caution. The evidence from the case series studies showed a wide variety of mortality and percentage well outcomes so that drawing conclusions from these studies as a whole is not possible.
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