Anorexia nervosa in a long-term perspective: results of the Heidelberg-Mannheim Study.
The long-term outcome of 84 anorexia nervosa patients was studied over a period of 12 years using global clinical ratings and differential physical findings in addition to standardized psychometric measurements. An unusual polarization into good and fatal outcomes was found, with a high recovery rate of 54% and a high mortality rate of 11%. When psychiatric and somatic comorbidity and psychosocial functioning were included in the assessment, the recovery rate was only 41% after 12 years. Clear cases of anorexia decreased steadily from 100% at clinical presentation to 67% after 2 years, 40% after 4 years, and 23% after 6 years. There was almost no further decline after the ninth year of follow-up (17%). Purging, physical symptoms, advanced age at clinical presentation, and a high social status were predictors for an unfavorable course. About 22% of the patients had suffered a relapse after remission. At first presentation, they were young and had a short duration of illness but showed severe psychiatric disorders. Results are discussed in terms of methodological and clinical issues involved in the long-term follow-up of anorexia nervosa patients.
Deter
H C
HC
Department of Psychosomatics, University Medical Center Steglitz, Free University of Berlin, Germany.
Herzog
W
W
D000328:Adult; D000856:Anorexia Nervosa / Q000401:mortality / Q000523:psychology / Q000628:therapy*; D002908:Chronic Disease; D015897:Comorbidity; D004038:Diet, Reducing / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D005858:Germany / Q000453:epidemiology; D006801:Humans; D010552:Personality Assessment; D011575:Psychoanalytic Therapy; D012917:Social Adjustment; D015996:Survival Rate; D016896:Treatment Outcome