Page 68 - The efficacy and effectiveness of psychological treatments for eating disorders - Elske van den Berg
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  68 Chapter 3
 A reliable change index (RCI) was established (Jacobson & Truax, 1991) for the responders as 0.67 change on the EDE-Q global score. RCI for the 2012-2014 sample was 65.3% and 81.6% for the 2015-2017 sample, a significant difference (Fisher’s exact test, p = .006). ITT analyses showed RCI of 71.1% for 2012-2014 and 78.8% for 2015-2017 sample, not a significant difference (F(1, 243.74) = 2.38, p = .124). Clini- cally significant change (CSC), defined as a RCI plus EDE-Q global score < 2.77, was achieved by 46.7% in 2012-2014 and 58.7% in 2015-2017, not a significant difference (Fisher’s exact test, p = .078); ITT analyses on CSC showed no significant difference either (50.6% in 2012-2014; 56.6% in 2015-2017; F(1, 314.06) = 1.17, p = .279).
When applying a more robust definition of remission (EDE-Q global score < 2.77, no eating disorder behaviors and BMI > 18.5), 38.4% of the 2012-2014 responders and 26.1% of the 2015-2017 responders achieved remission, a significant difference (Fish- er’s exact test, p = .046). Applying this definition to the imputed data did not show a significant difference (23.8% in 2012-2014, 31.9% in 2015-2017; F(1, 185.37) = 2.12, p = .147).
For outpatients, attending under 10 treatment sessions was regarded as dropout. In 2012-2014, 16.7 % of the outpatients dropped out, in 2015-2017, it was 11.9 %, not a significant difference (Fisher’s exact test, p = .110).
Care consumption
Inpatient admission rate dropped from 15.5% (37/239) in 2012-2014 to 10.9% (35/320) in 2015-2017 (χ2 = 2.52, p = .113), not a significant difference. Inpatient stay shortened significantly; in 2012-2014 mean duration was 14.1 weeks (SD = 7.5), in 2015-2017, it was 8 weeks (SD = 3.5) (MW-U = 348, p <.001). In addition, the number of day care contacts reduced significantly; in 2012-2014 23.4% of patients was offered day care (M= 42 days, SD = 29), in 2015-2017 4% of the inpatients received day care (M = 12, SD = 13), before being discharged (MW-U = 127.5, p <.001). On the over- all number of treatment sessions, no significant difference was found between 2012-2014 (M = 32.3, SD = 25.1) and 2015-2017 (M = 31.1, SD = 16.5) (MW-U = 41385, p = .096). For outpatients, underweight as well, in 2015-2017, mean number of sessions was 23.8 (SD = 11.4; range = 4-80); 38.4% (109/284) had 22-28 sessions, assess- ment sessions included.
Treatment costs
Table 4 shows that mean service costs dropped considerably between 2012-2014 and 2015-2017.



























































































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