6-YEAR COURSE OF BULIMIA-NERVOSA

Objective: Because little is known about the longer-term course of bul imia nervosa, the 2- and 6-year course and outcome of 196 consecutivel y treated females with bulimia nervosa-purging type (BN-P) was assesse d. Method: One hundred ninety-sir females with BN-P were assessed long itudinally at four points of time: at the beginning of therapy, at the end of therapy, at 2-year follow-up, and at 6-year follow-up. Self-ra ting scales as well as expert ratings from interview data were used. E ating disorder specific and general psychopathology was assessed. Resu lts: The general pattern of results over time showed substantial impro vement during therapy, a slight (in most cases nonsignificant) decline during the first 2 years after treatment, and further improvement and stabilization from 3 to 6 years posttreatment. At 6-year follow-up, 2 0.9% had BN-P, 0.5% BN-nonpurging type (BN-NP) 1.1% had shifted from B N to binge-eating disorder, 3.7% had anorexia nervosa, 1.6% were class ified as eating disorder not otherwise specified (ED-NOS), and 2 patie nts had died; obesity with a body mass index (BMI) of >30 was seen in 6.0%; the majority (71.7%) showed no major DSM-IV eating disorder. Con clusions: Based on a composite global outcome score at 6 years follow- up, 59.9% achieved a good outcome, 29.4% an intermediate outcome, 9.6% a poor outcome, and 2 (1.7%) persons were deceased. Course and outcom e were generally more favorable than in anorexia nervosa. (C) 7997 by John Wiley & Sons, Inc.