title: Long-term follow up of hospitalized pediatric anorexia nervosa restricting type.
abstract: BACKGROUND
  Information on long-term follow up of childhood-onset anorexia nervosa is scarce. This study investigated long-term (>10 years) course, outcome and prognostic factors for hospitalized childhood-onset anorexia nervosa restricting type (ANR).
  
  
  METHODS
  Forty-one ANR girls admitted to a single regional center participated. Median age at first admission was 13.3 years (range, 8.6-15.6 years). The longitudinal clinical course was retrospectively determined for a median follow-up period of 17.1 years (range, 10.4-21.1 years). We analyzed physical, psychological, and social variables to predict partial remission (PR) and full remission (FR).
  
  
  RESULTS
  The completion rate of follow up >10 years was high at 97%. At final evaluation (n = 38), distribution of prognosis was as follows: FR, n = 27 (71%); PR, n = 6 (16%); and non-remission, n = 5 (13%). The cumulative ratio of PR and FR increased during the first 5-6 years, and gradually reached a plateau at around 10 years. More than 10 years after the onset, one patient eventually achieved FR, and one patient died. Seven patients were rehospitalized and two died due to suicide during the entire follow up. On multivariate analysis, family disorders/problems rating score was a significant predictor of PR and FR.
  
  
  CONCLUSIONS
  This study included hospitalized ANR children aged ≤15 years, the youngest cohort ever reported. Long-term prognosis is generally favorable, but the mortality rate was 5%. Careful long-term follow up >10 years is needed to evaluate outcome of childhood-onset ANR, and family therapy is important in high-risk patients with family disorders/problems.
authors.affiliation: Department of Pediatrics, Nishi-Kobe Medical Center, Kobe, Japan.
authors.forename: Keiji
authors.initials: K
authors.lastname: Tasaka
authors.affiliation: Department of Pediatrics, Nishi-Kobe Medical Center, Kobe, Japan.
authors.forename: Kousaku
authors.initials: K
authors.lastname: Matsubara
authors.affiliation: Department of Psychiatry, Nishi-Kobe Medical Center, Kobe, Japan.
authors.forename: Shizuo
authors.initials: S
authors.lastname: Takamiya
authors.affiliation: Department of Psychiatry, Nishi-Kobe Medical Center, Kobe, Japan.
authors.forename: Shin-Ichi
authors.initials: SI
authors.lastname: Ishikawa
authors.affiliation: Department of Pediatrics, Nishi-Kobe Medical Center, Kobe, Japan.
authors.forename: Aya
authors.initials: A
authors.lastname: Iwata
authors.affiliation: Department of Pediatrics, Nishi-Kobe Medical Center, Kobe, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Nigami
mesh_terms: D000293:Adolescent; D000856:Anorexia Nervosa / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D053208:Kaplan-Meier Estimate; D010359:Patient Readmission / Q000706:statistics & numerical data; D011379:Prognosis; D016016:Proportional Hazards Models; D011613:Psychotherapy; D012008:Recurrence; D012074:Remission Induction; D012189:Retrospective Studies; D013405:Suicide / Q000706:statistics & numerical data; D055815:Young Adult
keywords: anorexia nervosa restricting type; childhood onset; long-term follow up; outcome; prognosis