Should bulimia nervosa be subtyped by history of anorexia nervosa? A longitudinal validation.
OBJECTIVE
To determine whether a past diagnosis of anorexia nervosa (AN) predicts longitudinal course and outcome among women with bulimia nervosa (BN).


METHODS
A subset (n = 176) of participants in the Longitudinal Study of Anorexia and Bulimia Nervosa who met DSM-IV criteria for BN either at study intake (n = 144) or during follow-up (n = 32; 4 had restricting AN at intake, 28 had binge/purge AN at intake) were included in this report. Over a median of 9 years, weekly eating disorder symptom data were collected from participants using the Longitudinal Interview Follow-up Examination, Eating Disorders Version.


RESULTS
While there were no between-group differences in likelihood of partial recovery, women with BN who had a history of AN were more likely to have a protracted illness, relapsing into AN during follow-up, compared to those with no AN history who were more likely to move from partial to full recovery.


CONCLUSIONS
Lifetime AN is an important prognostic indicator among women with BN and these longitudinal data would support the subtyping of BN on the basis of AN history.
Eddy
Kamryn T
KT
Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA. kamryn@bu.edu
Dorer
David J
DJ
Franko
Debra L
DL
Tahilani
Kavita
K
Thompson-Brenner
Heather
H
Herzog
David B
DB
D000293:Adolescent; D000328:Adult; D000856:Anorexia Nervosa / Q000453:epidemiology / Q000523:psychology*; D052018:Bulimia Nervosa / Q000145:classification* / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D002648:Child; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D015203:Reproducibility of Results; D014481:United States / Q000453:epidemiology