Conclusion
The literature reviewed in the NICE guidelines do not
strongly substantiate the Grade C level recommendation of
outpatient treatment in AN. Outpatient treatment regimens
reviewed in the NICE Guidelines differed markedly both in
the frequency of treatment and the therapeutic methods.
Thus, the comparability is limited. In our opinion, future
research is required to differentiate between patients who
profit from inpatient treatment versus those for whom outpatient
treatment suffices. If inpatient treatment of a particular
subgroup is proven more effective than outpatient treatment,
the required length of hospitalization, the mode of treatment
and treatment goals need to be determined. The characteristics
of this subgroup need to be delineated. In the light of potentially
low participation, low adherence and high drop-out rates
we are aware of the difficulties such research efforts pose.
Nevertheless, we need to advance the currently limited
knowledge as to appropriate treatment strategies; multi-center
studies are inevitable to achieve this goal.