10-YEAR FOLLOW-UP OF ANOREXIA-NERVOSA - CLINICAL COURSE AND OUTCOME

The clinical course and outcome of anorexia nervosa are presented in a 10-year followup study of 76 severely ill females with anorexia nervo sa who met specific diagnostic criteria and had participated in a well -documented hospital treatment study. Information was obtained on 100% of the subjects. A comprehensive assessment was made in 93% of the li ving subjects in specific categories of weight, eating and weight cont rol behaviours, menstrual function, anorexic attitudes, and psychologi cal, sexual, social and vocational adjustment. Five subjects had died, which gives a crude mortality rate of 6.6%. Standardized mortality ra tes demonstrated an almost 13-fold increase in mortality in the anorex ia nervosa subjects. Only eighteen (23.7%) were fully recovered. Sixty -four per cent developed binge-eating at some time during their illnes s, 57% at least weekly. Twenty-nine (41%) were still bulimic at follow -up. The high frequency and chronicity of the bulimic symptoms plus th e high rate of weight relapse (42% during the first year after hospita l treatment) suggest that intensive intervention is needed to help ano rexics restore and maintain their weight within a normal range and to decrease abnormal eating and weight control behaviours.