Outcome and clinical course in inpatient bulimic women: a 2- to 9-year follow-up study.
BACKGROUND
One previous follow-up study suggested that inpatient bulimic women do quite poorly; after an interval of 2 to 5 years, only 13% were recovered. To examine the course and outcome of a sample of patients with bulimia nervosa that was severe enough to require inpatient hospitalization, the authors conducted the following study.


METHODS
Women (N = 52) with DSM-III-R bulimia nervosa were sought 2 to 9 years after hospitalization. Prior to contact, a retrospective chart review was conducted to determine global functioning and admission diagnoses. At follow-up, patients participated in a 4 to 6 hour interview that assessed current and lifetime Axis I disorders (SCID-I), current Axis II disorders (PDE), eating behaviors (EAT, BSQ, EDI, PSR), global functioning (GAF), social adjustment (SAS-SR), and treatment and medical problems experienced since discharge. To assess the significance of differences between the recovered and the currently bulimic women, Yates-corrected chi-square tests and two-tailed t tests were used.


RESULTS
Of the 52 women, 46 were interviewed, 1 had died, and 5 could not be located. Of the 46 interviewed women, 39% had fully recovered, 20% had partially recovered, and 41% were currently bulimic. The likelihood of recovery increased with length of time since discharge. While medical problems related to the bulimia were few, treatment with phenelzine was associated with three reports of serious hypertensive episodes, one of which led to death. Global functioning before hospitalization, lifetime DSM-III-R Axis I diagnoses, and current Axis II diagnoses were not associated with outcome.


CONCLUSIONS
These findings suggest that even severely ill bulimic patients have a significant chance of achieving full recovery.
Fallon
B A
BA
Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, N.Y.
Walsh
B T
BT
Sadik
C
C
Saoud
J B
JB
Lukasik
V
V
D000293:Adolescent; D000328:Adult; D001835:Body Weight; D002032:Bulimia / Q000150:complications / Q000175:diagnosis* / Q000523:psychology; D005247:Feeding Behavior; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D006973:Hypertension / Q000139:chemically induced; D001523:Mental Disorders / Q000150:complications / Q000175:diagnosis; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D010624:Phenelzine / Q000009:adverse effects; D011569:Psychiatric Status Rating Scales; D012189:Retrospective Studies; D012720:Severity of Illness Index; D012917:Social Adjustment
D010624:Phenelzine