Twelve-year course and outcome of bulimia nervosa

2004 ◽  
Vol 34 (8) ◽  
pp. 1395-1406 ◽  
Author(s):  
MANFRED M. FICHTER ◽  
NORBERT QUADFLIEG

Background. Since little is known about the long-term course and outcome of bulimia nervosa, the authors designed a 12-year prospective longitudinal study with five cross-sectional assessments based on a large sample of consecutively treated females with bulimia nervosa (purging type) (BN-P).Method. One hundred and ninety-six females with BN-P were assessed (1) at the beginning of treatment, (2) at the end of treatment, (3) at 2-year follow-up, (4) at 6-year follow-up, and (5) at 12-year follow-up. In self-ratings as well as expert ratings based on interviews we assessed specific eating-disorder and general psychopathology.Results. The general pattern of results over time showed substantial improvement during treatment, slight (in most cases non-significant) decline during the first two years after the end of treatment, and further improvement and stabilization until 12-year follow-up. At that point the majority of patients (70·1%) showed no major DSM-IV eating disorder, 13·2% had eating disorders not otherwise specified, 10·1% had BN-P and 2% had died. Very few had undergone transition to anorexia nervosa or binge-eating disorders. Logistic regression analyses showed that psychiatric co-morbidity was the best and most stable predictor for eating-disorder outcome at 2, 6 and 12 years.Conclusions. Course and outcome of BN-P was generally more favourable than for anorexia nervosa.

2004 ◽  
Vol 34 (5) ◽  
pp. 843-853 ◽  
Author(s):  
D. L. FRANKO ◽  
P. K. KEEL ◽  
D. J. DORER ◽  
M. A. BLAIS ◽  
S. S. DELINSKY ◽  
...  

Background. Suicide is a common cause of death in anorexia nervosa and suicide attempts occur often in both anorexia nervosa and bulimia nervosa. No studies have examined predictors of suicide attempts in a longitudinal study of eating disorders with frequent follow-up intervals. The objective of this study was to determine predictors of serious suicide attempts in women with eating disorders.Method. In a prospective longitudinal study, women diagnosed with either DSM-IV anorexia nervosa (n=136) or bulimia nervosa (n=110) were interviewed and assessed for suicide attempts and suicidal intent every 6–12 months over 8·6 years.Results. Fifteen percent of subjects reported at least one prospective suicide attempt over the course of the study. Significantly more anorexic (22·1%) than bulimic subjects (10·9%) made a suicide attempt. Multivariate analyses indicated that the unique predictors of suicide attempts for anorexia nervosa included the severity of both depressive symptoms and drug use over the course of the study. For bulimia nervosa, a history of drug use disorder at intake and the use of laxatives during the study significantly predicted suicide attempts.Conclusions. Women with anorexia nervosa or bulimia nervosa are at considerable risk to attempt suicide. Clinicians should be aware of this risk, particularly in anorexic patients with substantial co-morbidity.


Author(s):  
Susan McElroy ◽  
Anna I. Guerdjikova ◽  
Nicole Mori ◽  
Paul E. Keck

This chapter addresses the pharmacotherapy of the eating disorders (EDs). Many persons with EDs receive pharmacotherapy, but pharmacotherapy research for EDs has lagged behind that for other major mental disorders. This chapter first provides a brief rationale for using medications in the treatment of EDs. It then reviews the data supporting the effectiveness of specific medications or medication classes in treating patients with anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED), and other potentially important EDs, such as night eating syndrome (NES). It concludes by summarizing these data and suggesting future areas for research in the pharmacotherapy of EDs.


Author(s):  
Pamela Keel

The epidemiology of eating disorders holds important clues for understanding factors that may contribute to their etiology. In addition, epidemiological findings speak to the public health significance of these deleterious syndromes. Information on course and outcome are important for clinicians to understand the prognosis associated with different disorders of eating and for treatment planning. This chapter reviews information on the epidemiology and course of anorexia nervosa, bulimia nervosa, and two forms of eating disorder not otherwise specified, binge eating disorder and purging disorder.


Author(s):  
Susan L. McElroy ◽  
Anna I. Guerdjikova ◽  
Anne M. O’Melia ◽  
Nicole Mori ◽  
Paul E. Keck

Many persons with eating disorders (EDs) receive pharmacotherapy, but pharmacotherapy research for EDs has lagged behind that for other major mental disorders. In this chapter, we first provide a brief rationale for using medications in the treatment of EDs. We then review the data supporting the effectiveness of specific medications or medication classes in treating patients with anorexia nervosa (AN), bulimia nervosa, binge eating disorder (BED), and other potentially important EDs, such as night eating syndrome (NES) and sleep-related eating disorder (SRED). We conclude by summarizing these data and suggesting future areas for research in the pharmacotherapy of EDs.


Author(s):  
Marco La Marra ◽  
Walter Sapuppo ◽  
Giorgio Caviglia

The aim of this study has been to investigate the dissociative phenomena and the difficulties related to perceive, understand and describe the proper ones and other people's emotional states in a sample of 53 patients with Eating Disorders. The recruited sample is made by 14 Anorexia Nervosa (AN) patients, 15 with Bulimia Nervosa (BN), 12 with Eating Disorder Non Otherwise Specified (EDNOS) and 12 with Binge Eating Disorder (BED). To all subjects was administred the Eating Disorder Inventory-2, the Dissociative Experiences Scale and the Scala Alessitimica Romana. In according with literature, we confirme the relationships among Eating Disorders, the dissociative phenomena and Alexithymia.


Nutrients ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 2834
Author(s):  
Lisa Brelet ◽  
Valentin Flaudias ◽  
Michel Désert ◽  
Sébastien Guillaume ◽  
Pierre-Michel Llorca ◽  
...  

Research about stigmatization in eating disorders (EDs) has highlighted stereotypes, prejudices, and discrimination against people with EDs, as well as their harmful effects on them, including self-stigma and a difficult recovery process. Whereas a recent review focused on the consequences of ED stigma, our work aimed to provide a broader synthesis of ED stigma, including its consequences, but also its content and distribution. More precisely, we focused on three EDs—namely, anorexia nervosa, bulimia nervosa, and binge eating disorder. Based on a systematic search of four major databases in psychology, the present scoping review includes 46 studies published between 2004 and 2021. We did not conduct any quality assessment of the studies included, because our aim was to provide a wide-ranging overview of these topics instead of an appraisal of evidence answering a precise research question. The review confirmed the existence of a common ED stigma: all individuals affected by EDs reviewed here were perceived as responsible for their situation, and elicited negative emotions and social distance. However, our review also depicted a specific stigma content associated with each ED. In addition, the demographic characteristics of the stigmatizing individuals had a notable influence on the extent of ED stigma: men, young adults, and low-income individuals appeared to be the most stigmatizing toward individuals with EDs. It is important to note that ED stigma had a negative effect on individuals’ eating disorders, psychological wellbeing, and treatment-seeking behavior. There is an urgent need for further research on the adverse effects of ED stigma and its prevention.


Author(s):  
Myrna M. Weissman ◽  
John C. Markowitz ◽  
Gerald L. Klerman

This chapter provides an overview of the use of IPT for patients with eating disorders. The most common eating disorders are anorexia nervosa, bulimia nervosa, and binge eating disorder. The chapter discusses the adaptations of IPT that have been used for the treatment of eating disorders and evaluates their performance in research studies. The assumption for testing IPT with eating disorders is that they occur in response to distress at poor social and interpersonal functioning and consequent negative mood, to which the patient responds with maladaptive eating behaviors. For anorexia nervosa, few data provide evidence for the benefit of IPT. For bulimia and binge eating disorder, however, IPT is considered a viable option for treatment and is recommended in numerous guidelines. A case example of a woman with bulimia nervosa is provided.


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