Recovery and relapse in anorexia and bulimia nervosa: a 7.5-year follow-up study.
OBJECTIVE
To assess the course and outcome of anorexia nervosa (AN) and bulimia nervosa (BN) at a median of 90 months of follow-up in a large cohort of women with eating disorders.


METHODS
A prospective, naturalistic, longitudinal design was used to map the course of AN and BN in 246 women. Follow-up data are presented in terms of full and partial recovery, predictors of time to recovery, and rates and predictors of relapse.


RESULTS
The full recovery rate of women with BN was significantly higher than that of women with AN, with 74% of those with BN and 33% of those with AN achieving full recovery by a median of 90 months of follow-up. Intake diagnosis of AN was the strongest predictor of worse outcome. No predictors of recovery emerged among bulimic subjects. Eighty-three percent of women with AN and 99% of those with BN achieved partial recovery. Approximately one third of both women with AN and women with BN relapsed after full recovery. No predictors of relapse emerged.


CONCLUSIONS
The findings suggest that the course of AN is characterized by high rates of partial recovery and low rates of full recovery, while the course of BN is characterized by higher rates of both partial and full recovery.
Harvard Medical School, Boston, USA.
D B
DB
Herzog
D J
DJ
Dorer
P K
PK
Keel
S E
SE
Selwyn
E R
ER
Ekeblad
A T
AT
Flores
D N
DN
Greenwood
R A
RA
Burwell
M B
MB
Keller
D000293:Adolescent; D000328:Adult; D000856:Anorexia Nervosa / Q000628:therapy*; D002032:Bulimia / Q000628:therapy*; D002908:Chronic Disease; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D020127:Recovery of Function; D012008:Recurrence; D012307:Risk Factors; D016896:Treatment Outcome