Evaluation of treatment and intermediate and long-term outcome of adolescent eating disorders.
BACKGROUND
A cohort of 60 adolescent eating-disordered patients that was consecutively admitted between 1979 and 1988 to a child and adolescent psychiatric university department in Berlin, Germany was followed up at a mean of 5-0 years and for a second time at a mean of 11.5 years.


METHODS
Each patient was personally interviewed and findings dealing with eating disorder symptoms and psychosocial functioning were rated on four-point scales. In addition, the duration of both in-patient and out-patient treatment and the Body Mass Index (BMI) were recorded.


RESULTS
Patients were in treatment for a mean of 33 % of the initial 5-year follow-up period, but this has dropped to a mean of 17% of the entire 11-year follow-up period. No predictors of treatment duration were found. The mortality rate was 8.3% at the second follow-up. The distribution of abnormal BMIs ( < 17.5) reflected a trend of improvement with increasing duration of follow-up. In comparison to the 5-year follow-up, fewer patients suffered from symptoms of the full clinical picture of an eating disorder at the 11-year follow-up. Among the surviving patients 80% recovered during the long-term course. There were few specific predictors of three different outcome criteria.


CONCLUSIONS
This outcome study of adolescent eating disorders provides further evidence that the long-term course of the disorders in terms of the eating pathology is better than can be expected after a few years. Very little can be said with regard to individual prognosis.
Steinhausen
H C
HC
Department of Child and Adolescent Psychiatry, University of Zürich, Switzerland.
Seidel
R
R
Winkler Metzke
C
C
D000293:Adolescent; D000328:Adult; D000856:Anorexia Nervosa / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D015992:Body Mass Index; D002032:Bulimia / Q000175:diagnosis / Q000628:therapy*; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006785:Hospitals, University; D006801:Humans; D017063:Outcome Assessment, Health Care; D010343:Patient Admission; D011567:Psychiatric Department, Hospital; D015996:Survival Rate