COURSE AND 2-YEAR OUTCOME IN ANOREXIC AND BULIMIC ADOLESCENTS

Objective: The aim of the study was the descriptive analysis of the tw o-year course of bulimia nervosa (BN; N = 32) and anorexia nervosa (AN ; N = 23) in adolescents who received intensive inpatient behavioral t reatment. Methods: Assessments were made on the basis of expert rating s (Structured Interview for Anorexia and Bulimia Nervosa [SIAB-P] Psyc hiatric Status Rating Scale for Bulimia/Anorexia Nervosa [PSRSB] Morga n-Russell Outcome Assessment Scale and Munich Diagnostic Check List [M DCL]) and self-ratings (SLAB-S [self-rating], Anorexia Nervosa Invento ry for self-rating [ANIS] Eating Disorder Inventory [EDI] SCL-90, and the parental Bonding Instrument [PBI]). Results: Females with BN maint ained their low normal weight. Females with AN maintained some of thei r weight increase induced during inpatient therapy. The BN group had a higher lifetime comorbidity with affective disorders while AN had a h igher comorbidity with substance use disorders. The status at two-year follow-up based on the PSRSB expert rating was as follows: 50% of the BN patients also fulfilled the Diagnostic Statistical Manual, third e dition, revised (DSM-III-R) criteria for BN at follow-rep while only 3 .1% of them fulfilled criteria for AN and 46.9% were below threshold o f a diagnosis for AN or BN according to DSM-III-R; of those former BN patients below diagnostic threshold for an eating disorder at follow-u p, 26.7% showed'' marked symptoms'' 26.7% were classified as ''partial remission,'' 13.3% had ''residual symptoms,'' and 33.3% had normalize d to their ''usual self.'' From the patients with AN on admission 30.4 % were classified as RN according to DSM-III-R at the two-year follow- up and 21.7% as BN. The remaining 47.8% were below diagnostic threshol d of DSM-III-X AN or BN of those 45.5% with ''marked symptoms,'' 27.3% with ''partial remission,'' 9.1% with ''residual symptoms,'' and 18.2 % had normalized to ''usual self''. Conclusions: At the two-year follo w-up almost half of the patients with AN and almost half of those with BN had no major eating disorder (AN, BN). A considerable number of th e AN patients developed BN in the two-year interval.