title: Predictors of rapid relapse in bulimia nervosa.
abstract: OBJECTIVE
  Relapse remains a significant concern in bulimia nervosa, with some patients relapsing within months of treatment completion. The purpose of the study was to identify predictors of relapse within the first 6 months following treatment.
  
  
  METHODS
  The 116 participants were bingeing and/or vomiting ≥ 8 times per month before day hospital (DH), and had ≤ 2 episodes per month in the last month of DH and the first month after DH. Rapid relapse was defined as ≥ 8 episodes per month for 3 months starting within 6 months.
  
  
  RESULTS
  The rate of rapid relapse was 27.6%. Patients who relapsed soon after DH had higher frequencies of bingeing and vomiting before treatment, engaged in less body avoidance before treatment and were more likely to be slow responders to treatment. Weight and shape concerns and body checking were not significant predictors.
  
  
  CONCLUSIONS
  More frequent bulimic symptoms accompanied by less body avoidance may indicate an entrenchment in the illness which in turn augurs a labored and transient response to DH treatment that is difficult to sustain after intensive treatment ends.
authors.affiliation: Department of Psychiatry, University Health Network, Toronto, Canada; Department of Psychiatry, University of Toronto, Toronto, Canada.
authors.forename: Marion P
authors.initials: MP
authors.lastname: Olmsted
authors.forename: Danielle E
authors.initials: DE
authors.lastname: MacDonald
authors.forename: Traci
authors.initials: T
authors.lastname: McFarlane
authors.forename: Kathryn
authors.initials: K
authors.lastname: Trottier
authors.forename: Patricia
authors.initials: P
authors.lastname: Colton
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D056912:Binge-Eating Disorder / Q000523:psychology / Q000628:therapy; D001828:Body Image; D001835:Body Weight; D052018:Bulimia Nervosa / Q000523:psychology / Q000628:therapy*; D005260:Female; D006801:Humans; D012008:Recurrence; D014839:Vomiting / Q000523:psychology
keywords: bulimia nervosa; rapid relapse; rapid response; relapse