Eating Disorder Symptoms and Length of Stay in Residential Treatment for Substance Use: A Brief Report

Abstract

Objective: Treatment dropout is common both among people in treatment for eating disorders and for substance use disorders. Because of the high rates of co-occurrence and mortality associated with these disorders, the purpose of the current study was to examine the relationship among eating disorder symptoms, length of stay, and decisions to leave against medical advice among individuals in substance use treatment. Methods: We analyzed de-identified medical record data for 122 adult women enrolled in residential treatment for substance use disorders over a 12-month period. Routine treatment intake included standardized assessments of eating disorders, depression, and substance use. Results: Participants averaged 43.1 years of age (SD = 10.7) and were primarily non-Hispanic Caucasian (n = 118, 96.7%). Approximately 8 (6.6%) patients met criteria for a probable eating disorder and 79 (64.8%) for a probable alcohol use disorder. Mean length of stay was 28.1 days (SD = 6.6) and 21 (17%) patients left against medical advice. Logistic regression analysis showed that eating disorder symptoms were significantly associated with decisions to leave treatment against medical advice after controlling for age, years of education, depression symptoms, alcohol problems, and drug problems: χ² = 14.88, df = 6, p =.02. This model accounted for 19.1% (Nagelkerke R²) of the variance in discharge type. Eating disorder symptoms were not associated with length of treatment. Conclusions: Our findings suggest the importance of assessing and monitoring eating disorder symptoms among individuals in treatment for substance use disorders.

Keywords:

• substance dependence
• eating disorders
• treatment length
• treatment dropout

DISCLOSURES

The authors report no financial relationships with commercial interests with regard to this manuscript. JoAnna Elmquist receives a graduate student stipend from the University of Tennessee. Dr. Shorey receives compensation as a consultant for Cornerstone of Recovery. Dr. Stuart received compensation as a consultant from the University of Texas Medical Branch–Galveston, Boston University, and Cornerstone of Recovery. He also received compensation for reviewing grants for the National Institutes of Health.

FUNDING

This work was supported, in part, by grant K24AA019707 from the National Institute on Alcohol Abuse and Alcoholism (NIAAA) awarded to the last author. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIAAA or the National Institutes of Health.