title: An 8-year longitudinal study of the natural history of threshold, subthreshold, and partial eating disorders from a community sample of adolescents.
abstract: The authors examined the natural history of threshold, subthreshold, and partial eating disorders in a community sample of 496 adolescent girls who completed annual diagnostic interviews over an 8-year period. Lifetime prevalence by age 20 years was 0.6% and 0.6% for threshold and subthreshold anorexia nervosa (AN), 1.6% and 6.1% for threshold and subthreshold bulimia nervosa (BN), 1.0% and 4.6% for threshold and subthreshold binge-eating disorder (BED), and 4.4% for purging disorder (PD). Overall, 12% of adolescents experienced some form of eating disorder. Subthreshold BN and BED and threshold PD were associated with elevated treatment, impairment, and distress. Peak age of onset was 17-18 years for BN and BED and 18-20 years for PD. Average episode duration in months was 3.9 for BN and BED and 5.1 for PD. One-year recovery rates ranged from 91% to 96%. Relapse rates were 41% for BN, 33% for BED, and 5% for PD. For BN and BED, subthreshold cases often progressed to threshold cases and diagnostic crossover was most likely for these disorders. Results suggest that subthreshold eating disorders are more prevalent than threshold eating disorders and are associated with marked impairment.
authors.affiliation: Department of Psychology, University of Texas at Austin, Texas, USA.
authors.forename: Eric
authors.initials: E
authors.lastname: Stice
authors.forename: C Nathan
authors.initials: CN
authors.lastname: Marti
authors.forename: Heather
authors.initials: H
authors.lastname: Shaw
authors.forename: Maryanne
authors.initials: M
authors.lastname: Jaconis
mesh_terms: D000293:Adolescent; D000856:Anorexia Nervosa / Q000145:classification / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D052018:Bulimia Nervosa / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D002648:Child; D003430:Cross-Sectional Studies; D018450:Disease Progression; D005260:Female; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D010555:Personality Inventory / Q000706:statistics & numerical data; D011594:Psychometrics / Q000706:statistics & numerical data; D012008:Recurrence; D012075:Remission, Spontaneous; D014481:United States; D055815:Young Adult
references.citation: J Adolesc Health. 2001 Mar;28(3):222-7
references.pmid: 11226845
references.citation: Aust N Z J Psychiatry. 2006 Feb;40(2):121-8
references.pmid: 16476129
references.citation: Int J Eat Disord. 1993 Nov;14(3):261-7
references.pmid: 8275062
references.citation: Int J Eat Disord. 2000 Dec;28(4):377-86
references.pmid: 11054784
references.citation: Psychosom Med. 2003 Jul-Aug;65(4):701-8
references.pmid: 12883125
references.citation: Behav Res Ther. 2006 Dec;44(12):1727-38
references.pmid: 16458252
references.citation: Eat Behav. 2004 Jan;5(1):13-25
references.pmid: 15000950
references.citation: J Am Acad Child Adolesc Psychiatry. 1999 Jul;38(7):829-37
references.pmid: 10405500
references.citation: J Abnorm Psychol. 2009 Feb;118(1):161-170
references.pmid: 19222322
references.citation: Am J Psychiatry. 1995 Jul;152(7):1052-8
references.pmid: 7793442
references.citation: Arch Gen Psychiatry. 2000 May;57(5):459-66
references.pmid: 10807486
references.citation: Int J Eat Disord. 2005 Nov;38(3):191-9
references.pmid: 16211629
references.citation: Int J Eat Disord. 2007 Nov;40 Suppl:S89-94
references.pmid: 17868124
references.citation: Int J Eat Disord. 2000 Jul;28(1):20-6
references.pmid: 10800010
references.citation: Biol Psychiatry. 2007 Feb 1;61(3):348-58
references.pmid: 16815322
references.citation: Int J Eat Disord. 2007 Nov;40 Suppl:S61-6
references.pmid: 17702021
references.citation: Psychol Med. 1990 May;20(2):383-94
references.pmid: 2356264
references.citation: Int J Eat Disord. 2006 Nov;39(7):550-5
references.pmid: 16791851
references.citation: J Am Acad Child Adolesc Psychiatry. 2000 Oct;39(10):1284-92
references.pmid: 11026183
references.citation: J Consult Clin Psychol. 2002 Oct;70(5):1119-28
references.pmid: 12362962
references.citation: J Pediatr. 1998 Feb;132(2):204-10
references.pmid: 9506629
references.citation: Arch Gen Psychiatry. 1999 Jan;56(1):63-9
references.pmid: 9892257
references.citation: Am J Psychiatry. 2002 Jan;159(1):140-2
references.pmid: 11772705
references.citation: Br J Psychiatry. 2005 Dec;187:573-8
references.pmid: 16319411
references.citation: Int J Eat Disord. 2000 Nov;28(3):311-6
references.pmid: 10942917
references.citation: J Am Acad Child Adolesc Psychiatry. 2003 May;42(5):587-93
references.pmid: 12707563
references.citation: Int J Eat Disord. 2007 Sep;40(6):505-14
references.pmid: 17607700
references.citation: Int J Eat Disord. 1999 Jan;25(1):45-54
references.pmid: 9924652
references.citation: Am J Psychiatry. 2006 Dec;163(12):2181-3
references.pmid: 17151172
references.citation: Br J Psychiatry. 2008 Apr;192(4):294-9
references.pmid: 18378993
references.citation: J Consult Clin Psychol. 2008 Apr;76(2):329-40
references.pmid: 18377128
references.citation: Int J Eat Disord. 2002 Nov;32(3):309-18
references.pmid: 12210645
references.citation: J Consult Clin Psychol. 2006 Apr;74(2):263-75
references.pmid: 16649871
references.citation: Int J Eat Disord. 2006 May;39(4):294-302
references.pmid: 16528679
references.citation: Int J Eat Disord. 2006 Sep;39(6):462-7
references.pmid: 16715488
references.citation: Lancet. 2003 Feb 1;361(9355):407-16
references.pmid: 12573387
references.citation: Eur Child Adolesc Psychiatry. 2003;12 Suppl 1:I78-90
references.pmid: 12567219
references.citation: Arch Gen Psychiatry. 1976 Sep;33(9):1111-5
references.pmid: 962494
references.citation: Int J Eat Disord. 2003 Nov;34(3):319-30
references.pmid: 12949923
references.citation: Arch Gen Psychiatry. 2000 Jul;57(7):659-65
references.pmid: 10891036
references.citation: Int J Eat Disord. 1997 Dec;22(4):339-60
references.pmid: 9356884
references.citation: Am J Psychiatry. 2001 Apr;158(4):570-4
references.pmid: 11282690
references.citation: Behav Res Ther. 1998 Mar;36(3):257-72
references.pmid: 9642846
references.citation: Int J Eat Disord. 2001 Mar;29(2):157-65
references.pmid: 11429978
references.citation: Curr Opin Psychiatry. 2006 Jul;19(4):389-94
references.pmid: 16721169
references.citation: J Nerv Ment Dis. 1980 Dec;168(12):736-40
references.pmid: 7452212