Postremission predictors of relapse in women with eating disorders.
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.
Keel
Pamela K
PK
Department of Psychology, E11 Seashore Hall, University of Iowa, Iowa City, Iowa 52242, USA. pamela-keel@uiowa.edu
Dorer
David J
DJ
Franko
Debra L
DL
Jackson
Safia C
SC
Herzog
David B
DB
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