Personality dimensions and treatment drop-outs among eating disorder patients treated with cognitive behavior therapy

Premature, unilateral interruption of inpatient treatment of eating disorders (ED) is a key factor limiting success. We evaluated the role of personality dimensions (temperament and character) in predicting drop-out in 145 consecutive ED patients (133 females) admitted to a cognitive behavior inpatient treatment. Baseline assessment included anthropometry, the Eating Disorder Examination, the Beck Depression Inventory, the State-Trait Anxiety Inventory, and the Temperament and Character Inventory (TCI). Treatment was based on the new transdiagnostic cognitive behavior theory of ED, adapted for inpatient setting; it was manual-based and lasted 20 weeks (13, inpatients; 7, residential day-hospital). Thirty-four patients (23.4%) discontinued treatment. Dropouts had a lower education, a higher prevalence of separation or divorce in the family, and lower scores at TCI Persistence scale. After correction for age, gender and BMI, Persistence maintained a significant effect on drop-out (odds ratio, 0.77; 95% confidence interval, 0.61 – 0.98; P = 0.033), and the association was confirmed by Kaplan-Meier analysis (Log-rank Mantel-Cox, P = 0.025). Eating disorder patients with low Persistence are significantly less likely to complete inpatient treatment. The results may be used to adapt treatment according to the temperament of individual patients.