Prospective 10-year Follow-up in Adolescent Anorexia Nervosa—Course, Outcome, Psychiatric Comorbidity, and Psychosocial Adaptation

Abstract

The aim of the present study was to follow up the long-term course of adolescent-onset anorexia nervosa by repeated assessment, to analyze the association between the course of the eating disorder and psychiatric comorbidity, and to evaluate psychosocial outcome. The sample consisted of 39 inpatients who were reinvestigated 3, 7, and 10 years after discharge. The patients and 39 controls matched for age, gender, and occupational status were assessed with structured interviews on DSM-III-R eating disorders, additional axis I and axis II psychiatric disorders, and psychosocial functioning. Results showed that 69 % of the original subjects met the criteria for full recovery at the 10-year follow-up. One patient (3%) still exhibited the full syndrome of restrictive anorexia nervosa, two patients (5%) the full syndrome of bulimia nervosa. None of the patients had died. Of the subjects, 51% currently had an axis I psychiatric disorder and 23% met the full criteria for a personality disorder. Apart from the eating disorder, anxiety disorders and avoidant-dependent and obsessive-compulsive personality disorders were the most common psychiatric diagnoses. There was a significant association between psychiatric comorbidity and the outcome of the eating disorder and between outcome and psychosocial adaptation. With regard to psychiatric morbidity and psychosocial functioning, long-term recovered patients did not differ significantly from normal controls. It is concluded that in most patients adolescent anorexia nervosa takes a prolonged course, although it seems to be more favorable than in adult-onset forms. Those who achieve complete recovery from the eating disorder have a good chance of overcoming other psychiatric disorders and to adapt to social requirements.

Epidemiological study of the influence of family and socioeconomic status in disorders of eating behaviour

“…In contrast to what one would expect from references made in the studies by several authors (Fornari et al, 1999;Herpertz-Dahlmann et al, 2001;Kendler, 2001), a greater consumption of alcohol, tobacco and other toxic substances has not been found in the patients belonging to more dysfunctional families among our patients, nor are psychiatric pathologies such as depression, anxiety, phobias, etc. presented more frequently; on the other hand, more frequent practice of sexual relations has been observed in patients from more dysfunctional families, but without finding any relationship between family functioning and satisfaction with sexual relationships.…”

Short-term outcome of anorexia nervosa in adolescents after inpatient treatment: a prospective study

“…Statistical methods: Seven key variables were identified as likely outcome predictors [14,24,25,27]: age, BMI at the beginning of treatment, BMI at the time of discharge, duration of eating disorder, age at onset, psychiatric comorbidity (Axis-I disorders), and purging behavior. To determine the relationship between co-varying predictor variables and outcome, as the dependant variable, multiple regression analysis was employed.…”

Algumas questões éticas no tratamento da anorexia nervosa

“…A distorção da percepção associada à inanição 16 e a comorbidade com a depressão são bem conhecidas, assim como o impacto dessas sobre a competência 17 . No entanto, há muitos outros fatores que devem ser levados em conta quando é julgada a competência em pacientes com AN 16,17 .…”

“…No entanto, há muitos outros fatores que devem ser levados em conta quando é julgada a competência em pacientes com AN 16,17 .…”