Treatment of Chronically Ill Patients

The treatment of patients with chronic eating disorders poses a particular challenge for every therapist and treatment team. Universal criteria for the application of specific interventions depending on certain stages of the disorder cannot be established. Comparative psychotherapy studies on treatment outcomes in patients with eating disorders show chronicity rates of up to 23% in adult patients with anorexia nervosa (AN) and bulimia nervosa (BN) (Keel and Brown 2010). In adolescent patients with AN, treatment success is generally much more positive and chronicity rates are lower. The severe and long-lasting courses of AN have received increasing attention in recent years. Regardless of specific conditions and settings, helpful basic principles can be formulated as guidelines for therapeutic action, with the help of which unnecessary “power struggles” and the “iatrogenic” chronicity of patients with chronic AN and BN can be avoided.