Long-Term Outcome and Mortality in Adolescent Girls 8 Years After Treatment for Anorexia Nervosa

Abstract

Objective

Assessment of the longer-term outcome of anorexia nervosa (AN) in female adolescent inpatients (N = 132).

Method

A follow-up (mean 8.2 years) after treatment was conducted. A subsample of 39 patients with at least 10 years of follow-up (mean 14 years) was defined.

Results

Over the 8-year follow-up period, the body mass index (BMI) increased from 14.33 (1.65) to 19.04 kg/m² (2.97; t[112] = 17.33, p < 0.001, d = 1.63), and BMI percentiles increased from 0.50 (1.14) to 24.96 (26.81; t[112] = 9.83, p < 0.001, d = 0.92). Remission was found in 32.5% (8-year total sample) and 48.6% (14-year subsample). In the 8-year total sample, 15.1% still had AN or had relapsed (8.1% in the 14-year subsample). A cross-over from AN to binge-eating disorder was rare. The main cross-over occurred from AN to an eating disorder not otherwise specified (37.5% and 27.0%, respectively). The standardized mortality ratio was 21.7.

Discussion

In the long run, eating disorder diagnoses decreased significantly. Although a considerable proportion of patients recovered from their eating disorder, the number of recovered patients remained limited, with long-term negative consequences in a large proportion of patients. Standardized mortality was excessive, calling for ever-better therapies. Additional studies are needed to show if improved therapies lead to a better long-term outcome.