title: Ten-year follow-up of anorexia nervosa: clinical course and outcome.
abstract: The clinical course and outcome of anorexia nervosa are presented in a 10-year follow-up study of 76 severely ill females with anorexia nervosa who met specific diagnostic criteria and had participated in a well-documented hospital treatment study. Information was obtained on 100% of the subjects. A comprehensive assessment was made in 93% of the living subjects in specific categories of weight, eating and weight control behaviours, menstrual function, anorexic attitudes, and psychological, sexual, social and vocational adjustment. Five subjects had died, which gives a crude mortality rate of 6.6%. Standardized mortality rates demonstrated an almost 13-fold increase in mortality in the anorexia nervosa subjects. Only eighteen (23.7%) were fully recovered. Sixty-four per cent developed binge-eating at some time during their illness, 57% at least weekly. Twenty-nine (41%) were still bulimic at follow-up. The high frequency and chronicity of the bulimic symptoms plus the high rate of weight relapse (42% during the first year after hospital treatment) suggest that intensive intervention is needed to help anorexics restore and maintain their weight within a normal range and to decrease abnormal eating and weight control behaviours.
authors.affiliation: Department of Psychiatry, University of Minnesota, Minneapolis, USA.
authors.forename: E D
authors.initials: ED
authors.lastname: Eckert
authors.forename: K A
authors.initials: KA
authors.lastname: Halmi
authors.forename: P
authors.initials: P
authors.lastname: Marchi
authors.forename: W
authors.initials: W
authors.lastname: Grove
authors.forename: R
authors.initials: R
authors.lastname: Crosby
mesh_terms: D000293:Adolescent; D000328:Adult; D000856:Anorexia Nervosa / Q000175:diagnosis* / Q000401:mortality / Q000523:psychology / Q000534:rehabilitation; D001835:Body Weight; D002032:Bulimia / Q000175:diagnosis / Q000401:mortality / Q000523:psychology / Q000534:rehabilitation; D002423:Cause of Death; D002648:Child; D003131:Combined Modality Therapy; D015897:Comorbidity; D005247:Feeding Behavior; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D015596:Nutrition Assessment; D010359:Patient Readmission / Q000706:statistics & numerical data; D010552:Personality Assessment; D012050:Rehabilitation, Vocational; D012917:Social Adjustment; D015996:Survival Rate; D016896:Treatment Outcome