Manfred Maximilian Fichter1,2, Norbert Quadflieg1, Ross D Crosby3,4, Sonja Koch1. 1. Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University (LMU), Munich, 80336, Germany. 2. Schön Klinik Roseneck affiliated with the Medical Faculty of the University of Munich (LMU), Prien, 83209, Germany. 3. Neuropsychiatric Research Institute, Fargo, North Dakota. 4. Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota.
Abstract
OBJECTIVE: Assessment of the long-term outcome of anorexia nervosa (AN) in a very large sample of inpatients (N = 1,693) and identification of predictors for poor outcome. METHOD: Over 25 years (mean 10 years), consecutively admitted inpatients of a specialized hospital were followed. A subsample of 112 patients with 20-year follow-up was defined. Bivariate comparisons and logistic regression analysis identified risk factors of poor outcome. RESULTS: Body mass index (BMI) increased during the follow-up period. Eating behavior as well as general psychopathology improved but did not reach the level of healthy controls. Remission was found in 30% (total sample) and in 40% (20-year follow-up subsample). Crossover from AN to binge-eating disorder or obesity was rare. The predictors of a negative course of illness included lower BMI at admission; a higher score on the Eating Disorder Inventory Maturity Fears subscale at admission; fewer follow-up years; and higher age at admission. The main diagnostic crossover occurred from AN to eating disorder not otherwise specified. Motherhood was related to better outcome. DISCUSSION: Many patients with very severe AN recover from their illness but AN also shows considerable long-term negative consequences. Over long time periods, survivors show improvement but better treatments for severe cases are still needed. Predictors of outcome included symptom severity, chronicity, and length of follow-up but not psychiatric comorbidity.
OBJECTIVE: Assessment of the long-term outcome of anorexia nervosa (AN) in a very large sample of inpatients (N = 1,693) and identification of predictors for poor outcome. METHOD: Over 25 years (mean 10 years), consecutively admitted inpatients of a specialized hospital were followed. A subsample of 112 patients with 20-year follow-up was defined. Bivariate comparisons and logistic regression analysis identified risk factors of poor outcome. RESULTS: Body mass index (BMI) increased during the follow-up period. Eating behavior as well as general psychopathology improved but did not reach the level of healthy controls. Remission was found in 30% (total sample) and in 40% (20-year follow-up subsample). Crossover from AN to binge-eating disorder or obesity was rare. The predictors of a negative course of illness included lower BMI at admission; a higher score on the Eating Disorder Inventory Maturity Fears subscale at admission; fewer follow-up years; and higher age at admission. The main diagnostic crossover occurred from AN to eating disorder not otherwise specified. Motherhood was related to better outcome. DISCUSSION: Many patients with very severe AN recover from their illness but AN also shows considerable long-term negative consequences. Over long time periods, survivors show improvement but better treatments for severe cases are still needed. Predictors of outcome included symptom severity, chronicity, and length of follow-up but not psychiatric comorbidity.
Authors: Cheri A Levinson; Elizabeth Cash; Karla Welch; Sacha Epskamp; Rowan A Hunt; Brenna M Williams; Ani C Keshishian; Samantha P Spoor Journal: Int J Eat Disord Date: 2020-11-11 Impact factor: 4.861
Authors: Anna Aulinas; Franziska Plessow; Reitumetse L Pulumo; Elisa Asanza; Christopher J Mancuso; Meghan Slattery; Christiane Tolley; Jennifer J Thomas; Kamryn T Eddy; Karen K Miller; Anne Klibanski; Madhusmita Misra; Elizabeth A Lawson Journal: J Clin Endocrinol Metab Date: 2019-10-01 Impact factor: 5.958
Authors: Ann F Haynos; Leah M J Hall; Jason M Lavender; Carol B Peterson; Scott J Crow; Bonnie Klimes-Dougan; Kathryn R Cullen; Kelvin O Lim; Jazmin Camchong Journal: Hum Brain Mapp Date: 2018-09-25 Impact factor: 5.038