Thyroid indices and treatment outcome in bulimia nervosa.
OBJECTIVE
This study examined the thyroxine (T4) and free T4 (FT4) status of women with bulimia nervosa and its value as a predictor of outcome.


METHODS
A total of 135 women with bulimia nervosa underwent 12-weeks cognitive behavioral therapy treatment. Prior to and at 3-year follow-up patients completed psychiatric assessments and serumT4 and FT4 were measured.


RESULTS
At 3-year follow-up, 71% had no eating disorder and 29% met criteria for any eating disorder diagnosis. Mean T4 and FT4 concentrations were within normal ranges. Pre-treatment T4 and FT4 concentrations were inversely associated with food restriction and purging frequency, respectively. Compared with women with no eating disorder, those with any eating disorder at follow-up had lower pretreatment T4 concentrations. When pre-treatment food restriction, oral contraceptive use and binge frequency where controlled for, low T4 concentration was the only predictor of eating disorder diagnosis at follow-up.


CONCLUSIONS
Low T4 concentrations at pretreatment may be a predictor of poor outcome in bulimia nervosa.
Gendall
K A
KA
University Department of Psychological Medicine, Christchurch School of Medicine, University of Otago, Christchurch, New Zealand. kgendall@hotmail.com
Joyce
P R
PR
Carter
F A
FA
McIntosh
V V
VV
Bulik
C M
CM
D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D002032:Bulimia / Q000097:blood* / Q000523:psychology / Q000628:therapy*; D015928:Cognitive Behavioral Therapy / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D011237:Predictive Value of Tests; D011569:Psychiatric Status Rating Scales; D012044:Regression Analysis; D013961:Thyroid Gland / Q000473:pathology*; D013974:Thyroxine / Q000097:blood*; D016896:Treatment Outcome
D013974:Thyroxine