Abstract
Patients with anorexia nervosa (AN) had statistically more frequent strong feelings against hospitalization compared to patients with bulimia nervosa or control subjects. We attempted to utilize this aversion in outpatient treatment of AN by setting a body weight that required hospitalization. The therapy was conducted as follows : 1) The patient's family should refrain from mentioning the body weight and food intake of the patients. 2) A body weight limit permitting outpatient treatment was set according to the patient's mental and physical conditions. Hospitalization would occur if the patient's weight fell below this limit within a given period of time. 3) The body weight requiring hospitalization was gradually raised in consultation with the patient. 4) If the body weight permitting continued outpatient treatment was not reached within the predetermined time, hospitalizaion occurred. 5) Even if a patient did not achieve the target weight, hositalization might be postponed under certain circumstances. As anorexia nervosa patients have a strong hospital aversion, this method was well accepted by the patients and had a success rate of approximately 80%. A therapy utilizing this characteristic by setting a body weight requiring hospitalization was extremely efiicacious as an outpatient treatment method, and should be considered as a basic outpatient therapy for AN. In this study, we compare the frequency of hospital aversion among patients with AN received a therapy which had set a body weight requiring hospitalization before and after treatment. The proportions of subjects responding hospital aversion were many before as well as after treatment. On the basis of this results we consider that hospital aversion of AN is very important and is a kind of the patient's sense which is diffcult to change.
