title: Relapse from remission at two- to four-year follow-up in two treatments for adolescent anorexia nervosa.
abstract: OBJECTIVE
  Long-term follow-up studies documenting maintenance of treatment effects are few in adolescent anorexia nervosa (AN). This exploratory study reports relapse from full remission and attainment of remission during a 4-year open follow-up period using a convenience sample of a subgroup of 65% (n = 79) from an original cohort of 121 participants who completed a randomized clinical trial comparing family-based therapy (FBT) and adolescent-focused individual therapy (AFT).
  
  
  METHODS
  Follow-up assessments were completed up to 4 years posttreatment (average, 3.26 years). Available participants completed the Eating Disorder Examination as well as self-report measures of self-esteem and depression at 2 to 4 years posttreatment.
  
  
  RESULTS
  Two participants (6.1%) relapsed (FBT: n = 1, 4.5%; AFT: n = 1, 9.1%), on average 1.98 years (SD = 0.14 years) after remission was achieved at 1-year follow-up. Ten new participants (22.7%) achieved remission (FBT: n = 1, 5.9%; AFT: n = 9, 33.3%). Mean time to remission for this group was 2.01 years (SD = 0.82 years) from 1-year follow-up. There were no differences based on treatment group assignment in either relapse from full remission or new remission during long-term follow-up. Other psychopathology was stable over time.
  
  
  CONCLUSIONS
  There were few changes in the clinical presentation of participants who were assessed at long-term follow-up. These data suggest that outcomes are generally stable posttreatment regardless of treatment type once remission is achieved. Clinical trial registration information-Effectiveness of Family-Based Versus Individual Psychotherapy in Treating Adolescents With Anorexia Nervosa; http://www.clinicaltrials.gov/; NCT00149786.
authors.affiliation: University of Chicago. Electronic address: legrange@uchicago.edu.
authors.forename: Daniel
authors.initials: D
authors.lastname: Le Grange
authors.affiliation: Stanford University, Stanford, CA.
authors.forename: James
authors.initials: J
authors.lastname: Lock
authors.affiliation: University of Chicago.
authors.forename: Erin C
authors.initials: EC
authors.lastname: Accurso
authors.affiliation: Stanford University, Stanford, CA.
authors.forename: W Stewart
authors.initials: WS
authors.lastname: Agras
authors.affiliation: Stanford University, Stanford, CA.
authors.forename: Alison
authors.initials: A
authors.lastname: Darcy
authors.affiliation: Stanford University, Stanford, CA.
authors.forename: Sarah
authors.initials: S
authors.lastname: Forsberg
authors.affiliation: Stanford University, Stanford, CA.
authors.forename: Susan W
authors.initials: SW
authors.lastname: Bryson
mesh_terms: D000293:Adolescent; D000856:Anorexia Nervosa / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D002648:Child; D003866:Depressive Disorder / Q000523:psychology / Q000628:therapy; D005196:Family Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D011613:Psychotherapy; D012008:Recurrence; D012074:Remission Induction; D012649:Self Concept
keywords: adolescence; adolescent-focused treatment; anorexia nervosa; family-based treatment; long-term follow-up