PSYCHOLOGICAL CHARACTERISTICS AND DSM-III-R DIAGNOSES AT 6-YEAR FOLLOW-UP OF ADOLESCENT ANOREXIA-NERVOSA

Objective: To examine the relationship between psychiatric disorder an d psychological characteristics at 6-year follow-up of adolescent-onse t anorexia nervosa. Method: Twenty-three subjects were interviewed by telephone using the Structured Clinical Interview for DSM-III-R diagno sis. These subjects and 23 demographically similar controls completed standardized questionnaires that assessed their defense and coping sty les, level of depression, defensiveness, and eating disorder psychopat hology. Results: Of the anorexic subjects 35% had no DSM-III-R diagnos is, 43% an eating disorder, (9% anorexia nervosa, 17% bulimia nervosa, 22% eating disorder not otherwise specified), 30% an affective disord er, and 43% an anxiety disorder at follow-up. Factors at presentation associated with good outcome included greater use of mature defenses, less depression, and a lower drive for thinness. Psychological charact eristics of anorexic subjects with good outcome resembled those of con trols except that the former anorexics expressed greater dissatisfacti on with their bodies and reported less use of cognitive avoidance as a coping mechanism. Anorexic subjects with continuing psychiatric probl ems differed from controls on most of the measures studied. Conclusion s: Distribution of psychiatric disorders at follow-up is similar for a dolescent and adult-onset anorexia nervosa. Self-report measures of so me psychological characteristics are useful prognostic indicators. Abs ence of psychiatric disorder at follow-up is associated with normaliza tion of many psychological characteristics.