title: A pilot case series using qualitative and quantitative methods: biological, psychological and social outcome in severe and enduring eating disorder (anorexia nervosa).
abstract: OBJECTIVE
  We explore the level of disability and quality of life in participants with severe and enduring eating disorder (anorexia nervosa).
  
  
  METHODS
  We use qualitative and quantitative methods to assess in detail eleven participants with a 10-year history of anorexia nervosa. Outcomes for quality of life are compared with those of a sample of primary care patients with moderate-severe depression. Outcomes for living skills are compared with a standardized community sample of patients with schizophrenia.
  
  
  RESULTS
  Despite scoring highly for communication skills and levels of responsibility, participants were as impaired as the sample of patients with schizophrenia for self-care and social contact. Participants were severely depressed and scores for quality of life mirrored those of the primary care population. Qualitative data illustrate intrapersonal and interpersonal avoidance leading to self-neglect and social isolation despite social skills.
  
  
  CONCLUSIONS
  Quality of life and living skills are as impaired as those of other severe and enduring mental illnesses.
authors.affiliation: Department of Mental Health Sciences, Royal Free and University College Medical School, London, United Kingdom. jamesarkell@nhs.net
authors.forename: James
authors.initials: J
authors.lastname: Arkell
authors.forename: Paul
authors.initials: P
authors.lastname: Robinson
mesh_terms: D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D000856:Anorexia Nervosa / Q000523:psychology*; D016022:Case-Control Studies; D002648:Child; D002908:Chronic Disease; D003866:Depressive Disorder / Q000523:psychology; D005260:Female; D006801:Humans; D008131:London; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011788:Quality of Life; D012559:Schizophrenia; D012565:Schizophrenic Psychology; D012648:Self Care; D012720:Severity of Illness Index; D012917:Social Adjustment; D012934:Social Isolation