title: Postremission predictors of relapse in women with eating disorders.
abstract: OBJECTIVE
  The authors sought to evaluate patterns and predictors of relapse among women with eating disorders.
  
  
  METHODS
  Interviews were conducted biannually to annually to assess symptoms of eating disorders, axis I disorders, treatment, and psychosocial function on a weekly basis for women diagnosed with anorexia nervosa (N=136) or bulimia nervosa (N=110) and prospectively followed for 9 years. At the last follow-up, 229 (93%) of the subjects had been retained in the study group.
  
  
  RESULTS
  Relapse occurred in 36% of the women with anorexia nervosa and 35% of the women with bulimia nervosa. Women with intake diagnoses of anorexia nervosa, restricting subtype, tended to develop bulimic symptoms during relapse, whereas women with intake diagnoses of anorexia nervosa, binge-purge subtype, or bulimia nervosa tended to return to bulimic patterns during relapse. Greater body image disturbance contributed to a risk of relapse in both eating disorders, and worse psychosocial function increased the risk of relapse in bulimia nervosa.
  
  
  CONCLUSIONS
  These results may explain the long-term efficacy of interpersonal therapy for bulimia nervosa and suggest that focused body image work during relapse prevention may enhance long-term recovery from eating disorders.
authors.affiliation: Department of Psychology, E11 Seashore Hall, University of Iowa, Iowa City, Iowa 52242, USA. pamela-keel@uiowa.edu
authors.forename: Pamela K
authors.initials: PK
authors.lastname: Keel
authors.forename: David J
authors.initials: DJ
authors.lastname: Dorer
authors.forename: Debra L
authors.initials: DL
authors.lastname: Franko
authors.forename: Safia C
authors.initials: SC
authors.lastname: Jackson
authors.forename: David B
authors.initials: DB
authors.lastname: Herzog
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D000856:Anorexia Nervosa / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D001828:Body Image; D002032:Bulimia / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D015897:Comorbidity; D001068:Feeding and Eating Disorders / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D011613:Psychotherapy; D012307:Risk Factors; D055502:Secondary Prevention; D012917:Social Adjustment; D016896:Treatment Outcome