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 Adolescent-onset anorexia nervosa: 18-year outcome

2009 ◽  
Vol 194 (2) ◽  
pp. 168-174 ◽  
Author(s):  
Elisabet Wentz ◽  
I. Carina Gillberg ◽  
Henrik Anckarsäter ◽  
Christopher Gillberg ◽  
Maria Råstam
Keyword(s):  
Anorexia Nervosa ◽  
Eating Disorder ◽  
Age At Onset ◽  
Autistic Traits ◽  
Obsessive Compulsive ◽  
Term Outcome ◽  
Community Screening ◽  
Long Term Outcome ◽  
Axis I

BackgroundThe long-term outcome of anorexia nervosa is insufficiently researched.AimsTo study prospectively the long-term outcome and prognostic factors in a representative sample of people with teenage-onset anorexia nervosa.MethodFifty-one people with anorexia nervosa, recruited by community screening and with a mean age at onset of 14 years were compared with 51 matched comparison individuals at a mean age of 32 years (18 years after disorder onset). All participants had been examined at ages 16 years, 21 years and 24 years. They were interviewed for Axis I psychiatric disorders and overall outcome (Morgan–Russell assessment schedule and the Global Assessment of Functioning).ResultsThere were no deaths. Twelve per cent (n=6) had a persisting eating disorder, including three with anorexia nervosa. Thirty-nine per cent of the anorexia nervosa group met the criteria for at least one psychiatric disorder. The general outcome was poor in 12%. One in four did not have paid employment owing to psychiatric problems. Poor outcome was predicted by premorbid obsessive–compulsive personality disorder, age at onset of anorexia nervosa and autistic traits.ConclusionsThe 18-year outcome of teenage-onset anorexia nervosa is favourable in respect of mortality and persisting eating disorder.

Value of family background and clinical features as predictors of long-term outcome in anorexia nervosa: four-year follow-up study of 41 patients

1975 ◽  
Vol 5 (4) ◽  
pp. 355-371 ◽  
Author(s):  
H. G. Morgan ◽  
G. F. M. Russell
Keyword(s):  
Anorexia Nervosa ◽  
Clinical Features ◽  
Psychiatric Treatment ◽  
Psychiatric Hospitals ◽  
Term Outcome ◽  
Premorbid Personality ◽  
Long Term Outcome ◽  
Follow Up Study

SynopsisThis is a prognostic study on 41 patients with anorexia nervosa (including three males) who satisfied defined diagnostic criteria. The patients had all been admitted to a metabolic unit where the mainstay of treatment was nursing care aimed at rapid restoration of body weight. A follow-up was conducted after a minimum lapse of four years after each patient's discharge from hospital. The outcome of the patient's illness was expressed in terms of an ‘average outcome score’ and a ‘general outcome’. The series included a relatively high proportion of patients with a long illness who had received previous psychiatric treatment. Their families tended to come from higher social classes; a disturbed relationship with the patient was frequent. Premorbid disturbances in personality development were also common. The immediate response to treatment was excellent, with the majority of the patients returning to a normal weight, but relapses after discharge were common and readmissions were necessary in half the patients. At follow-up, the patients fell into the following defined categories: ‘good’ (39%), ‘intermediate’ (27%), ‘poor’ (29%), died (5%). Most of the patients who failed to recover continued to display the clinical features characteristic of anorexia nervosa. Among predictors of an unfavourable outcome were found a relatively late age of onset, a longer duration of illness, previous admissions to psychiatric hospitals, a disturbed relationship between the patient and other members of the family, and premorbid personality difficulties. It is suggested that the long-term outcome found in a series will depend more on factors influencing patient referral according to the severity of their illness, rather than on the method of treatment itself. The illness may last several years before eventual improvement or recovery, and a follow-up study must be extended over at least four years to be meaningful. An accurate prediction of eventual outcome is almost impossible, but late recoveries justify an optimistic outlook and continued therapeutic endeavour.

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 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.

A 15-year follow-up study of patients with panic disorder

2003 ◽  
Vol 18 (8) ◽  
pp. 401-408 ◽  
Author(s):  
Sven Andersch ◽  
Jerker Hetta
Keyword(s):  
Panic Disorder ◽  
Favourable Outcome ◽  
Drug Trial ◽  
Panic Attacks ◽  
Daily Functioning ◽  
Short Term Treatment ◽  
Term Outcome ◽  
Long Term Outcome

AbstractBackgroundPanic disorder (PD) is generally regarded as a chronic condition with considerable variation in severity of symptoms.AimsTo describe the long-term outcome of naturalistically treated PD.MethodsFifty-five outpatients with PD, who participated in a placebo-controlled drug trial of the efficacy of alprazolam and imipramine 15 years ago were reassessed with the same instruments used in the original study.ResultsComplete recovery (no panic attacks and no longer on medication during the last 10 years) was seen in 18% of patients, and an additional 13% recovered but were still on medication. Fifty-one percent experienced recurrent anxiety attacks whereas 18% still met diagnostic criteria for PD. The incidence of agoraphobia decreased from 69% to 20%. Patients with agoraphobia at admission tended to have a poorer long-term outcome according to daily functioning compared with patients without agoraphobia at admission, although both groups reported improved daily functioning at follow-up. Maintenance medication was common. No benzodiazepine abuse was reported.ConclusionPD has a favourable outcome in a substantial proportion of patients. However, the illness is chronic and needs treatment. The short-term treatment given in the drug trial had no influence on the long-term outcome.

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.

Anorexia Nervosa: Long-term Outcome in 50 Female Patients

1984 ◽  
Vol 145 (4) ◽  
pp. 407-413 ◽  
Author(s):  
Anne Hall ◽  
Enid Slim ◽  
Fiona Hawker ◽  
Clare Salmond
Keyword(s):  
Anorexia Nervosa ◽  
Eating Disorder ◽  
Outcome Measures ◽  
Dysthymic Disorder ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Female Patients ◽  
Eating Disorder Symptoms ◽  
Psychiatric State

SummaryFifty consecutively referred female patients with anorexia nervosa were followed-up to identify those completely healthy at a minimum of four years (mean eight years) since onset. As well as using Morgan's Outcome Measures, an independent psychiatrist elicited details of food/weight pre-occupation and psychiatric state. The outcome results, based on weight and menstruation, (36% ‘good’, 36% ‘intermediate’, and 26% ‘poor’ including 2% dead, and 2% not assessed) did not differ significantly from those of the three similar published studies on similar patients; 62% of patients continued to have some food/weight pre-occupation. DSM III criteria for a psychiatric disorder other than eating disorder were fulfilled by 50%; dysthymic disorder was common (34%), occurring exclusively in patients with continuing eating disorder symptoms, while only 20% of the sample were free of any physical or mental abnormality. Of 52 prognostic factors studied, only four were significantly related to the outcome measures. Length of illness at presentation was the only prognostic factor common to all four similarly conducted studies.

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 SAT0495 LONG TERM OUTCOME OF JUVENILE IDIOPATHIC ARTHRITIS IN ADULTHOOD; THE MONOCENTRIC EXPERIENCE OF 520 PATIENTS FOLLOWED FOR 20 YEARS IN A TRANSITION TERTIARY CLINIC OF PEDIATRIC RHEUMATOLOGY.

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1204.2-1204
Author(s):  
I. Pontikaki ◽  
S. Carbogno ◽  
F. Corona ◽  
A. Petaccia ◽  
R. Cimaz
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Educational Level ◽  
Disease Duration ◽  
Age At Onset ◽  
Disease Onset ◽  
Clinical Manifestations ◽  
Term Outcome ◽  
Long Term Outcome

Background:Juvenile Idiopathic Arthritis (JIA) is a chronic pediatric inflammatory disease that shows many differences compared to adult-onset arthritis. The different clinical manifestations, the assessment and the management of JIA is the reason that the transition from childhood to adulthood is an important multidimensional process that emphasizes a lot of aspects.Objectives:To describe the long-term outcome of JIA.Methods:Five-hundred and twenty patients affected by JIA and referred to a transition care rheumatology tertiary centre were considered between 1999 and 2019. The outcome assessment included remission, disease duration, medications, number of prosthesis implantation, pregnancies, mortality and social integration (employment status and educational level).Results:A hundred and thirty-eight (26%) males and 382 (73%) females were included; 157 (30%) patients were lost to follow up. The mean age of the patients was 27 (18-57) years, with a mean age at onset of 8 years and an average disease duration of 19 years. Subtypes of JIA at disease onset included 252 (48%) oligoarthritis, 134 (26%) polyarthritis, 64 (12%) systemic arthritis, 22 (4%) psoriatic arthritis, 43 (8%) enthesitis related arthritis and 1 (0.1%) undifferentiated arthritis. Ninty-three (18%) patients suffered of uveitis. Ninty-five implant prosthesis and 16 arthrodesis were recorded. At follow up 198 (38%) patients were on remission of which 107 (20%) off medication. Among the 322 patients still on medication, 84 (16%) were under treatment with oral steroids, 226 (43%) with sDMARDs and 249 (40%) with bDMARDs. Five deaths (1%) occurred in this cohort. Two hundred and thirty-five subjects had a higher educational level, 327 had an employment. We have data of twenty-nine pregnancies. The transition age was considered after the age of 16 years old. The key word for the management of this cohort was the multidisciplinary approach towards each patient, with the collaboration of other specialists (ophthalmologist, orthopedic, dermatologist, gastroenterologist, obstetric and psychologist).Conclusion:In the era of biologic therapy the long-term outcome of JIA underwent an outstanding improvement regarding a lot of variables. Two hundred and thirty-two patients were still followed, not only because of the continuation of the biological therapy, but also for a multidisciplinary care even during remission. JIA often persists over the adulthood, therefore the long term follow-up and care of these patients needs to be conducted by a rheumatologist expertized in JIA in collaboration with other specialists.Disclosure of Interests:None declared

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