EPA-1131 – Do we Neglect the Addictive Dimension of Eating Disorders? Clinical Qualitative Study of Subjects That Dropped Out From Outpatient Treatment

Abstract

Introduction:

According to literature dropout predicts insufficient results for inpatient treatment for anorexia and poor prognosis for adolescents or adults, with proven increased tendency to subsequent admissions. There are few qualitative studies on dropout, and its high rates for EDs remain a concern for clinicians and researchers alike.

Objective:

To analyze in greater depth the ’addictive’ dimension of EDs – a category of analysis found by the clinical qualitative study, which has been little explored by literature.

Method:

Clinical qualitative method and semi-structured in-depth interviews recorded and fully transcribed. Sample composed according to data saturation, consisting of 8 ≥18 y.o. dropout patients diagnosed with EDs at a specialized outpatient unit in a public university hospital. Theoretical basis relies on scientific literature review on EDs and addiction, and on the psychodynamic description of EDs as ’addictions’.

Results:

The in depth analysis of the categories ’enslavement to addiction (compulsively)’ - addictive dimension of anorexia and bulimia, ’I don’t like if things get out of my control’ – dropout as relief, and ’Anorexia and Bulimia is for life’ – attachment to the symptom signals elements for treatment based on the ’addictive/compulsive’ lived experience.

Conclusion:

The findings support refinement of treatment approach while understanding EDs in their addictive dimension, with possible impact on compliance. This often neglected facet is revealed by research subjects, adding symbolic elements considered with the discussion of neurobiology and psychoanalytic theory, demonstrating significant association between EDs and addiction and pointing out to new paths for treatment innovation.