Ten-year follow-up of adolescent-onset anorexia nervosa: personality disorders.
OBJECTIVE
To study the development of personality disorders, especially those involving obsessions, compulsions, and social interaction problems, in a representative group of anorexia nervosa (AN) cases.


METHODS
The prevalence of personality disorders, obsessive-compulsive disorder, and autism spectrum disorders at mean age 24 years (10 years after reported onset) was examined in 51 adolescent-onset AN cases recruited after community screening and 51 comparison cases matched for age, sex, and school. All 102 cases had originally been examined at age 16 years and followed up at 21 years. At 24 years, structured and validated psychiatric diagnostic interviews were performed by a psychiatrist who was blind to original diagnosis. The majority of AN cases (94%) were weight-restored.


RESULTS
Personality disorders, particularly cluster C, and autism spectrum disorders were overrepresented in the AN group. Obsessive-compulsive personality disorder and/or autism spectrum disorder was diagnosed in a subgroup of AN cases in all 3 studies. This subgroup had a very poor psychosocial outcome.


CONCLUSIONS
Persistent problems with obsessions, compulsions, and social interaction characterized a substantial minority of weight-restored AN cases at 10-year follow-up. These problems appear to be constitutional rather than a result of AN, and they may warrant a different treatment approach.
Nilsson
E W
EW
Department of Child and Adolescent Psychiatry, Annedals Clinics, Göteborg University, Sweden. ewn@medfak.gu.se
Gillberg
C
C
Gillberg
I C
IC
Råstam
M
M
D000293:Adolescent; D000328:Adult; D000856:Anorexia Nervosa / Q000150:complications* / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009771:Obsessive-Compulsive Disorder / Q000209:etiology / Q000523:psychology; D010554:Personality Disorders / Q000209:etiology* / Q000523:psychology; D011379:Prognosis; D012919:Social Behavior