Long-term outcome and psychiatric comorbidity of adolescent-onset anorexia nervosa

2019 ◽  
Vol 25 (1) ◽  
pp. 33-44 ◽  
Author(s):  
Susana Andrés-Pepiñá ◽  
Maria Teresa Plana ◽  
Itziar Flamarique ◽  
Sonia Romero ◽  
Roger Borràs ◽  
...  
Keyword(s):  
Anorexia Nervosa ◽  
Control Group ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Statistical Manual ◽  
Diagnostic And Statistical Manual ◽  
Increased Risk ◽  
A Current

Objective: To assess the outcome of adolescents with anorexia nervosa (AN) about 20 years after first treatment. Methods: Sixty-two women diagnosed with AN during adolescence were invited to participate. Of these 62 patients, 38 agreed to participate and were assessed with a battery of questionnaires and interviews. A control group of 30 women of similar age was also assessed. Results: Of the patients who completed the full assessment, 13 (34%) presented some degree of eating disorder (ED) at follow-up (10 (26%) met full Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5) criteria for an ED and 3 (8%) showed partial remission of an ED). The remaining 25 (66%) patients had fully recovered from AN. The duration of untreated illness before admission was significantly associated with an increased risk of a current ED (odds ratio (OR) = 3.334 (1.3–8.7); p = .014). Of the patients who had recovered totally from their ED, 24% showed another psychiatric disorder. This percentage rose to 70% in patients with a current ED. Conclusion: Sixty-six percent of adolescents who completed the assessment achieved remission of their AN. Comorbidity was more common in the current ED group. The variable that best predicted complete remission was the number of years without treatment, showing the importance of detection and early intervention.

ANOREXIA NERVOSA

PEDIATRICS ◽  
1982 ◽  
Vol 70 (4) ◽  
pp. 525-525
Author(s):  
Robert J. Haggerty
Keyword(s):  
Anorexia Nervosa ◽  
Early Onset ◽  
Age Of Onset ◽  
Outcome Studies ◽  
Psychosomatic Disorder ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Follow Up Studies

Anorexia nervosa is a serious psychosomatic disorder which most typically begins between 16 and 18 years of age. Clinicians have often held that early onset (eg, ages 11 to 15) is associated with a better outcome. This paper reviews the long-term outcome studies on anorexia nervosa and concludes that this contention is not supported by available data. The methodologies of seven outcome studies that focus on an early onset population are critiqued, and it is concluded that two methodologies are strong. Because of the increasing prevalence of anorexia nervosa, this once rare disorder can now be more easily investigated, and consequently better follow-up studies, which examine potential prognostic factors including age of onset, should be forthcoming.

Long term outcome of childhood onset headache: A prospective community study

Cephalalgia ◽  
2017 ◽  
Vol 38 (6) ◽  
pp. 1159-1166 ◽  
Author(s):  
Matti Sillanpää ◽  
Maiju M Saarinen
Keyword(s):  
Young Adulthood ◽  
Childhood Onset ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Recurrent Headache ◽  
Childhood Migraine ◽  
Early School ◽  
Increased Risk

Purpose To examine prevalence, course, and long-term outcome of childhood migraine and other headaches. Method Using questionnaires, 1185 children were followed for recurrent headaches at ages seven, 14 and 32 years, respectively. Results At age seven years, 4.0% of the 1185 children (girls 3.7%, boys 4.3%) had migraine and 24% (25%/23%) had nonmigrainous headache. In adulthood, 16% (22%/8%) had migraine and 60% (64%/54%) nonmigrainous headache. Childhood migraine persisted into adulthood in 65% of females and 21% of males, and nonmigrainous headache in 62% and 59%, respectively. After childhood, 17% of females and 7% of males started to have episodes of migraine. No recurrent headache during the follow-up was reported by 11% (6%/16%). In a multivariate analysis, compared with no childhood headache, childhood migraine increased the risk of adulthood migraine by 3.36-fold (95% CI 1.94–5.82) and that of nonmigrainous headache by 1.72-fold (1.14–2.60). Discussion and conclusions Headaches are generally as common in preschool girls as boys. From early school years, headaches steadily increase up to young adulthood, but among boys the prevalence levels off after adolescence. About two thirds of children experienced changes in their headache status during a 25-year follow-up. Any kind of recurrent headache at school entry predicts an increased risk of headache in young adulthood. Special attention should be paid to girls and particularly those girls who have recurrent headache when they start school.

Long-term outcome of a phase III trial on neoadjuvant chemoradiation with capecitabine and irinotecan in patients with locally advanced rectal cancer: Updated results of the CinClare trial.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 3603-3603
Author(s):  
Ji Zhu ◽  
Xinchen Sun ◽  
Anwen Liu ◽  
Yaqun Zhu ◽  
Tao Zhang ◽  
...  
Keyword(s):  
Locally Advanced ◽  
Rectal Adenocarcinoma ◽  
Phase Iii ◽  
Control Group ◽  
Genotype 1 ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Ugt1a1 Genotype

3603 Background: Adding UGT1A1-guided irinotecan to capecitabine-based neoadjuvant chemoradiotherapy (CRT) significantly increased the pathological complete response (pCR) rate nearly doubling [J Clin Oncol. 2020 Dec 20;38(36):4231-4239]. Here, results of long-term outcome are reported. Methods: Eligible patients with clinical stage II/III rectal adenocarcinoma, UGT1A1 genotype *1*1 or *1*28 were randomized to the control group: pelvic radiation of 50 Gy/25 fractions with concurrent capecitabine, followed by a cycle of oxaliplatin and capecitabine; or the experimental group: radiation with capecitabine combined with weekly irinotecan 80 mg/m2 for patients with *1*1 or 65 mg/m2 for patients with *1*28, followed by a cycle of irinotecan and capecitabine. Surgery was scheduled for 8 weeks after completion of CRT. Five cycles of adjuvant XELOX chemotherapy were administered regardless of the pathologic result. Patients were stratified by UGT1A1 genotype (*1*1 vs. *1*28) clinical T stage (cT3 vs. cT4) and tumor distance from the anal verge (≤5 cm vs. > 5 cm). The primary end point of pCR was reached. Survival time was calculated from the date of randomization to the date of event or the last follow-up. Secondary endpoints were defined as local failure for local control (LC), tumor recurrence or death from any cause for disease-free survival (DFS), and death from any cause for overall survival (OS). Results: Of the 360 patients initially enrolled, 356 were evaluated as the modified intention-to-treat population (n = 178 in both groups). A total of 311 patients underwent surgery and pCR was achieved in 80 patients, another 10 patients undergo a watch-and-wait approach after achieving cCR. With a median follow-up time of 48 months (Q25-Q75, 41-55 months), 57 deaths (33 and 24), 17 local failures (11 and 6) and 69 distant metastases (37 and 32) were observed, respectively. Overall, the 4y LC rate were 93% and 96% in control and experimental groups, with estimated LC HR of 0.53 (95% confidence interval [CI], 0.20-1.43), the 4y DFS rates were 69% and 74% (HR = 0.74, 95% CI 0.49-1.10), and the 4y OS were 80% and 85%, (HR = 0.70, 95% CI 0.42-1.19), respectively. In the subgroup analysis, irinotecan showed a significant improvement in DFS (HR = 0.77, 95% CI 0.61-0.98) and OS (HR = 0.71, 95% CI 0.51-0.98) in UGT1A1 *1*1 patients. Conclusions: The addition of irinotecan to standard capecitabine-based CRT had a tendency towards improving LC, DFS, and OS, but without reaching statistical significance. UGT1A1 *1*1 patients seem to benefit the most from irinotecan. Molecular studies and subsequent therapies should be considered. Clinical trial information: NCT02605265.

scholarly journals Anorexia nervosa: 30-year outcome

2019 ◽  
Vol 216 (2) ◽  
pp. 97-104 ◽  
Author(s):  
Sandra Rydberg Dobrescu ◽  
Lisa Dinkler ◽  
Carina Gillberg ◽  
Maria Råstam ◽  
Christopher Gillberg ◽  
...  
Keyword(s):  
Anorexia Nervosa ◽  
Eating Disorder ◽  
Psychiatric Treatment ◽  
Age At Onset ◽  
Favourable Outcome ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Symptom Recovery

BackgroundLittle is known about the long-term outcome of anorexia nervosa.AimsTo study the 30-year outcome of adolescent-onset anorexia nervosa.MethodAll 4291 individuals born in 1970 and attending eighth grade in 1985 in Gothenburg, Sweden were screened for anorexia nervosa. A total of 24 individuals (age cohort for anorexia nervosa) were pooled with 27 individuals with anorexia nervosa (identified through community screening) who were born in 1969 and 1971–1974. The 51 individuals with anorexia nervosa and 51 school- and gender-matched controls were followed prospectively and examined at mean ages of 16, 21, 24, 32 and 44. Psychiatric disorders, health-related quality of life and general outcome were assessed.ResultsAt the 30-year follow-up 96% of participants agreed to participate. There was no mortality. Of the participants, 19% had an eating disorder diagnosis (6% anorexia nervosa, 2% binge-eating disorder, 11% other specified feeding or eating disorder); 38% had other psychiatric diagnoses; and 64% had full eating disorder symptom recovery, i.e. free of all eating disorder criteria for 6 consecutive months. During the elapsed 30 years, participants had an eating disorder for 10 years, on average, and 23% did not receive psychiatric treatment. Good outcome was predicted by later age at onset among individuals with adolescent-onset anorexia nervosa and premorbid perfectionism.ConclusionsThis long-term follow-up study reflects the course of adolescent-onset anorexia nervosa and has shown a favourable outcome regarding mortality and full symptom recovery. However, one in five had a chronic eating disorder.

scholarly journals A critical analysis of recent data on the long-term outcome of antipsychotic treatment

2018 ◽  
Vol 49 (5) ◽  
pp. 750-753 ◽  
Author(s):  
Joanna Moncrieff ◽  
Sandra Steingard
Keyword(s):  
Negative Symptoms ◽  
First Episode ◽  
Antipsychotic Treatment ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Level Of Functioning ◽  
Risk Of Death ◽  
Increased Risk

AbstractNew studies of long-term outcomes claim to show that taking antipsychotics on a continuous and indefinite basis is the best approach for people diagnosed with a first episode of psychosis or schizophrenia. A 10-year follow-up of a trial of quetiapine maintenance, for example, found a higher proportion of people with a poor composite outcome in the group initially randomised to placebo. However, most people classified as showing poor outcome were rated as having a mild score on a single psychotic symptom; there were no differences in overall symptoms, positive or negative symptoms or level of functioning. Moreover, 16% of participants did not have a follow-up interview and data from the end of the original trial were used instead. A study using a Finnish database suggested that mortality and readmission were higher in people who did not start long-term antipsychotic treatment or who discontinued it as compared with long-term continuous users. However, the analysis did not control for important confounders and is likely to reflect the fact that people who do not comply with treatment are at higher risk of death due to underlying health risks and behaviours. The analysis showed a slightly higher risk of readmission among non-users of antipsychotics compared with long-term users and a more substantial increased risk among people who discontinued treatment. However, follow-up ceased at the first readmission and therefore eventual, long-term outcome was not assessed. Speed of reduction and whether it was done with or without clinical support were also not distinguished.

scholarly journals Long-Term Outcome of Adolescent Anorexia Nervosa: Family Treatment Apartments Compared With Child Psychiatric Inpatient Treatment

2021 ◽  
Vol 12 ◽  
Author(s):  
Ulf Wallin ◽  
Riitta Holmer
Keyword(s):  
Anorexia Nervosa ◽  
Hospital Care ◽  
Psychiatric Inpatient ◽  
Family Treatment ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Child Psychiatric ◽  
The Family

Introduction: The family is rarely involved in treatment when the patient with anorexia nervosa (AN) is hospitalized. Family treatment apartment (FTA) represents an intervention that includes the family in the intensive treatment of AN. This study compares the short- and long-term outcomes of adolescents treated in FTA with those who received inpatient hospital care. In FTA, the parents are responsible for providing meal support, whereas in hospital care, the staff is responsible.Methods: Sixty-eight previous patients admitted during the period 1990–2009 participated in a follow-up, 43 from the FTA where the whole family is admitted for treatment and 25 from regular psychiatric inpatient care. The follow-up consisted of a personal meeting with structured interviews, measurement of height and weight, and self-rating questionnaires.Result: Readmissions due to weight loss within 6 months from discharge were less common in the FTA group. At follow-up, 14.2 years after admission, there was no difference in eating disorder pathology between the groups. There were significantly lower scores on general psychiatric pathology and significantly higher scores on quality of life in the FTA group.Discussion: The treatment in FTA aims to give the family the ability to handle AN when it is most challenging. FTA may thus provide a helpful context for treatment with a basic sense of security along with skills that could contribute to better general mental health at follow-up.

Short- and Long-term Retention of Challenge Course Outcomes: A Classroom-based Longitudinal Study

2016 ◽  
Vol 40 (2) ◽  
pp. 152-164
Author(s):  
David P. Schary ◽  
Tyler Wozniak ◽  
Seth E. Jenny ◽  
Geoffrey S. Morrow
Keyword(s):  
Future Research ◽  
Control Group ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Challenge Course ◽  
Course Experience Questionnaire ◽  
Course Experience ◽  
Course Outcomes

The purpose of this study was to examine the retention of challenge course outcomes with the addition of intentional follow-up activities. The Challenge Course Experience Questionnaire (CCEQ) was administered to 101 participants in an introductory college course. The sample was divided into two separate groups: experimental group (EG; n = 67) and control group (CG; n = 34). Both groups completed a classroom-based challenge course program. Participants in the EG also included guided reflection-based activities throughout the semester and a facilitator-led activity. The CG only participated in the initial challenge course program. All participants significantly increased in CCEQ variables immediately following the program. However, the three-month follow-up revealed that the majority of variables decreased to preprogram levels for both groups. However, the variables had larger decreases in the CG. These findings have implications for challenge course programming in terms of long-term outcome retention. Suggestions for facilitators and future research are provided.

Long Term Outcome of Anorexia Nervosa

1993 ◽  
Vol 10 (2) ◽  
pp. 93-102 ◽  
Author(s):  
Lyndall M. Jones ◽  
W.K. Halford ◽  
Roger T. Dooley
Keyword(s):  
Anorexia Nervosa ◽  
Strong Predictor ◽  
Significant Degree ◽  
Self Report ◽  
Social Maladjustment ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Clinically Significant

The long-term outcome (mean follow-up period 5.7 years) for 20 patients with anorexia nervosa was assessed on a comprehensive battery of self-report inventories and a structured clinical interview. Two thirds of the cohort were improved to a clinically significant degree at follow-up, but the majority still showed higher than normal scores on inventories of anorexic symptomatology, social maladjustment, anxiety, and hostility. The remaining one third were unimproved and demonstrated a broad range of impairment including distorted attitudes toward eating, overconcern about body shape, poor social functioning, high levels of anxiety, hostility, depression, and external locus of control. Moderate to strong correlations were found across outcome measures. Longer duration of eating difficulties before presentation was a strong predictor of poor long-term outcome, suggesting a chronic relapsing form of the disorder occurred in a subgroup of patients.

scholarly journals Long-Term Efficacy of Variable-Thread Tapered Implants—A Retrospective, Clinical and Radiological Evaluation

Medicina ◽  
2020 ◽  
Vol 56 (11) ◽  
pp. 564
Author(s):  
Oliver Blume ◽  
Eva Maria Schnödt ◽  
Michael Back ◽  
Jan IR Wildenhof ◽  
Florian A. Probst ◽  
...  
Keyword(s):  
Risk Factors ◽  
Primary Stability ◽  
Common Reason ◽  
Long Term Results ◽  
Control Group ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Potential Risk Factors

Background and Objective: There is multifaceted evidence that variable-thread tapered implants (VTTIs) offer high primary stability but few regarding the long-term success. This retrospective clinical and radiological cohort study assessed the long-term outcome of VTTIs. Material and Methods: All patients treated in an OMFS practice with NobelActive Internal® VTTI between October 2007 and September 2011 were invited for clinical examination. The outcome variables were (i) survival rate, (ii) implant success according to the “Health Scale for Dental Implants” and (iii) prevalence of peri-implantitis. Furthermore, the effect of local and systemic risk factors was investigated. Results: In 81 subjects (46 females and 35 males, mean age 65.6 years) 270 implants (157 VTTIs and 113 others as a control group) were analyzed. In 7 out of 81 patients (8.6%), 8 out of 157 VTTIs (5.1%) and 5 out of 113 other implants (4.4%) were lost. Peri-implantitis, defined as (i) presence of bleeding on gentle probing (0.25 N) or exudation and (ii) radiographic bone loss exceeding 0.5 mm since implant insertion to last follow-up, was the most common reason for implant loss (11 out of 13, 84.6%). Sixty-six out of 87 VTTIs (75.9%) were successful. Seventeen out of 42 patients (40.5%) developed peri-implantitis on 29 out of 79 VTTI sites (36.7%). Plaque and missing keratinized peri-implant mucosa were identified as potential risk factors for the development of peri-implantitis. Conclusion: Variable-thread tapered implants showed good long-term results, even in low bone quality. Peri-implantitis was the most common reason for implant failure and may be connected to certain risk factors.

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