Predictors of long-term recovery in anorexia nervosa and bulimia nervosa: Data from a 22-year longitudinal study
Section snippets
Participants
Participants were recruited from Boston-area outpatient eating disorder services (1987-1991) if they met the following inclusion criteria: DSM-III-R (American Psychiatric Association, 1987) AN or BN diagnosis; female; minimum age of 12 years; residence within 200 miles of Boston; English speaking; and no evidence of organic brain syndrome or terminal illness.
Of the 294 women meeting study criteria, 250 (85.0%) agreed to participate, and four dropped out prior to the first follow-up. Thus, the
Recovery rates at 22 years
Recovery status at Wave II for the observed and imputed data is presented in Table 1. At the 22-year follow-up, nearly two-thirds of the sample had recovered. Specifically, 62.8% of those originally diagnosed with AN and 68.2% of those originally diagnosed with BN met the criteria for recovery (Eddy et al., 2017).
Predictors of non-recovery status (AN-R, AN-BP, or BN) relative to recovery at 22 years
Results from the multinomial logistic regression analysis examining predictors of non-recovery status (AN-R, AN-BP, and BN) relative to recovery at 22 years are presented in Table 2.
Discussion
The goal of the current study was to identify predictors of long-term recovery in eating disorders. In our analyses examining the odds of having a particular diagnosis at 22 years (AN-R, AN-BP, or BN), a diagnosis of major depression at the start of the study strongly and uniquely predicted having a diagnosis of AN-R relative to being recovered at the 22-year assessment. For AN-BP, the picture was different. Not surprisingly, having more clinically significant symptoms of anorexia and bulimia
Financial support
Support for this study came from grants from the National Institute of Mental Health (D.B.H., R01 MH-38333): and (D.B.H. and K.T.E., R03 MH-094832).
Conflicts of interest
None.
Ethical standards
The authors assert that all procedures contributing to this work comply with the ethical standards of the relevant national and institutional committees on human experimentation and with the Helsinki Declaration of 1975, as revised in 2008.
Acknowledgements
The authors wish to thank the participants for giving their time to help us learn more about the course and outcome of eating disorders and the research assistants who have worked on this project throughout the years.
References (43)
- et al.
What does remission tell us about women with eating disorders? Investigating applications of various remission definitions and their associations with quality of life
J. Psychosomatic Res.
(2014) - et al.
Defining recovery from an eating disorder: conceptualization, validation, and examination of psychosocial functioning and psychiatric comorbidity
Behav. Res. Ther.
(2010) - et al.
Recovery and relapse in anorexia and bulimia nervosa: a 7.5-year follow-up study
J. Am. Acad. Child Adolesc. Psychiatry
(1999) - et al.
The prevalence and correlates of eating disorders in the National Comorbidity Survey Replication
Biol. Psychiatry
(2007) - et al.
Health-related quality of life among adolescents with eating disorders
J. Psychosomatic Res.
(2014) Neurobiology of anorexia and bulimia nervosa
Physiology Behav.
(2008)- et al.
Predictors and moderators of outcome in family-based treatment for adolescent bulimia nervosa
J. Am. Acad. Child Adolesc. Psychiatry
(2008) - et al.
Dimensional measures of personality as a predictor of outcome at 5-year follow-up in women with bulimia nervosa
Psychiatry Res.
(2011) Outcome of eating disorders
Child Adolesc. Psychiatric Clin. N. Am.
(2009)- et al.
A review of the definitions of outcome used in the treatment of bulimia nervosa
Clin. Psychol. Rev.
(2012)